[Pyoderma gangrenosum: treatment with plasma exchange (4 cases)].

Four patients with pyoderma gangrenosum were treated by plasma exchange. The series included one woman (cervical localization) and three men (sural localization in 1 case, multiple trunk and facial localizations in the second case and multiple, recurrent localizations on trunk and limbs in the third case). In 2 cases another disease was associated (ulcerative colitis in 1 case and Crohn's disease in the other). Between 6 and 12 plasma exchange sessions were carried out in combination with corticotherapy (1/2 mg/kg/day). Results in 2 cases were rated as very good: progression of the disease interrupted and no further pain after the 1st plasma exchange, rapid healing of lesions (a skin graft was necessary for a lesion of hand exposing tendons). A good result was obtained in the 3rd case with interruption of progression of lesions after the 1st plasma exchange but slower relief of pain. Treatment was considered a failure in the 4th case since there was no obvious regression in lesions or pain. Three of the 4 patients had no recurrences, one patient developing recurrences on 4 occasions responding well to plasma exchange each time. Pyoderma gangrenosum is a good indication for use of plasma exchange, which limits extension of ulcerating lesions, suppresses or reduces pain and decreases esthetic prejudice.