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当前和新兴的治疗坏疽性脓皮病的趋势:文献综述。

Current And Emerging Trends In The Management Of Pyoderma Gangrenosum: A Literature Review.

机构信息

Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan.

Dow University of Health Sciences, Karachi, Pakistan.

出版信息

J Ayub Med Coll Abbottabad. 2023 Oct-Dec;35(Suppl 1)(4):S774-S784. doi: 10.55519/JAMC-S4-12085.

DOI:10.55519/JAMC-S4-12085
PMID:38406909
Abstract

The first description of Pyoderma gangrenosum (PG) was made about a century ago. It is difficult to understand the aetiology, pathophysiology, and therapy of PG. This disease is believed to be caused by a systemic inflammatory response to neutrophil chemotaxis and faulty innate immune system control. Nearly fifty percent of the cases have underlying systemic symptoms. Significant improvements in PG management have been made over the years. The main goals of treatment are to reduce inflammation and speed up the healing of the PG wound. Even though the most recent medicines show promise, they are found on isolated case reports. The majority of patients are typically managed with topical treatment and local wound care, while resistant cases necessitate immunosuppressive medications. More progress can be made with improvements in technology in deciphering this complex disease and getting a greater understanding of the condition. The present standard therapies for refractory PG are not well supported by studies. In refractory PG, corticosteroids and cyclosporine have historically been administered. Tumour necrosis factor inhibitors are becoming a viable option; nonetheless, this requires careful research and upkeep. This review intended to describe the current trends in managing the PG. Several next-generation treatment options including the conventional therapies introduced to treat PG. We encompass the advantages and disadvantages of new treatments for PG.

摘要

坏疽性脓皮病(PG)的首次描述是在一个世纪前。其病因、发病机制和治疗方法都难以理解。这种疾病被认为是由中性粒细胞趋化和先天免疫系统控制失常引起的全身性炎症反应引起的。近一半的病例有潜在的全身症状。多年来,PG 的治疗已取得显著进展。治疗的主要目标是减轻炎症并加速 PG 伤口的愈合。尽管最近的药物有一定效果,但这些效果仅在孤立的病例报告中得到证实。大多数患者通常采用局部治疗和局部伤口护理进行管理,而耐药病例则需要免疫抑制药物。通过改善技术来解析这种复杂疾病并更好地了解病情,可以取得更多进展。目前针对难治性 PG 的标准疗法并没有得到充分的研究支持。在难治性 PG 中,皮质类固醇和环孢素一直被使用。肿瘤坏死因子抑制剂成为一种可行的选择;尽管如此,这仍需要仔细的研究和维护。本综述旨在描述 PG 的当前治疗趋势。包括介绍用于治疗 PG 的传统疗法在内的几种下一代治疗选择。我们涵盖了 PG 新治疗方法的优缺点。

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