PYODERMA GANGRENOSUM
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For the treatment of pyoderma gangrenosum, I would add intralesional 
steroids to the border.  Very effective.

Daniel Mitchell MD
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cyclosporine is the most reliable Rx for PG - I'm not aware of any failures.
I've seen 1 case do well with Cromolyn, but that was a superficial PG -- if
you have bad trouble you'd best go right to Cyclosporine.

K Smith MD
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I have a 75 year old woman who has pyoderma grangrenosum.
She responded to Dapsone 150 mg/day and prednisone.  On 60 mg/day she had 
partial healing of the ulcers.  However she could not tolerate the prednisone 
and has flared on 20 mg/day.  I have recently begun intralesional injections 
and 
changed the dapsone to Immuran.  I am trying to get Thalidomide for her. 
Have any of you used thalidomide for pyoderma gangrenosum?  Do you have any 
references? My medline searches have not been productive. 


Harry Goldin, M.D.
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In Canada, cyclosporine would be far easier to obtain than thalidomide. 
How hypertensive is this patient? Did her blood pressure increase while 
on prednisone? A few clinicians that I've spoken to consider CSA to be 
the drug of first choice for PG. As long as you're watching the BP and 
renal function, CSA is a relatively safe drug. 


Harvey Lui
University of British Columbia
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Thalidomide has a mode of action similar to cyclosporine so I suppose it
would work for PG, but usually I'd just go with CyA unless the patient had
poor kidneys, hypertension, or some other problem with CyA.

KC Smith MD FRCPC
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				4.17.96