Understanding pyoderma gangrenosum: a review.

CONTEXT: Diagnosis and management of pyoderma gangrenosum, a chronic, ulcerative cutaneous inflammatory disease often associated with systemic disease, requires a multidisciplinary approach. No large-scale, controlled trials have been conducted and, as a consequence, the knowledge of this condition is largely based on anecdotal reports. OBJECTIVE: To investigate current understanding of the diagnosis and management of pyoderma gangrenosum. DESIGN: Critical review article. Two hundred eighty-six articles, limited to articles in English and pertaining to humans, were retrieved and reviewed from a MEDLINE search spanning the years 1960-2000. CONCLUSIONS: Diagnosis of pyoderma gangrenosum often requires consultation by multiple specialists in different fields of medicine. Treatment is individually tailored and depends on disease severity and the presence of associated disease. Local treatment is sufficient for mild disease, and the use of immunosuppressive agents is reserved for severe or refractory cases, with cyclosporin being the agent of choice. The long-term outcome for these patients has not been established.