Matis W L, Ellis C N, Griffiths C E, Lazarus G S
Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia.
Arch Dermatol. 1992 Aug;128(8):1060-4.
Pyoderma gangrenosum is a chronic inflammatory ulcerative skin disease of unknown origin, often associated with various diseases including inflammatory bowel disease, inflammatory arthritis, monoclonal gammopathies, hepatitis, and myeloproliferative disorders. Treatment of associated systemic disorders may improve the ulcers, but lesions may be recalcitrant and persist for months to years. Therapy for pyoderma gangrenosum includes high-dose systemic corticosteroids, sulfa drugs such as sulfasalazine, clofazimine, and immunosuppressive agents such as mercaptopurine and azathioprine; these drugs are sometimes ineffective.
We present a series of 11 patients with pyoderma gangrenosum, with a wide range of underlying diseases, whose ulcers were refractory to usual therapy and who were treated with low-dose cyclosporine. Ten of the 11 patients cleared rapidly and completely with cyclosporine therapy.
Cyclosporine should be seriously considered as a primary form of treatment for pyoderma gangrenosum.
坏疽性脓皮病是一种病因不明的慢性炎症性溃疡性皮肤病，常与多种疾病相关，包括炎症性肠病、炎性关节炎、单克隆丙种球蛋白病、肝炎和骨髓增殖性疾病。治疗相关的全身性疾病可能会改善溃疡情况，但病变可能顽固难愈，持续数月至数年。坏疽性脓皮病的治疗方法包括大剂量全身性皮质类固醇、磺胺类药物如柳氮磺胺吡啶、氯法齐明以及免疫抑制剂如巯嘌呤和硫唑嘌呤；这些药物有时无效。
我们报告了一组11例坏疽性脓皮病患者，他们患有多种基础疾病，其溃疡对常规治疗无效，接受了小剂量环孢素治疗。11例患者中有10例经环孢素治疗后迅速且完全痊愈。
环孢素应被认真考虑作为坏疽性脓皮病的主要治疗方式。
