Treatment of pyoderma gangrenosum with mycophenolate mofetil as a steroid-sparing agent.

Abstract:

BACKGROUND:Mycophenolate mofetil (MMF) has enjoyed increasing popularity as an emerging immunosuppressant treatment for various autoimmune dermatologic conditions, including pyoderma gangrenosum (PG). OBJECTIVE:The aim of this study was to examine the efficacy and safety of MMF as used in PG. METHODS:A retrospective chart review was conducted for all patients with PG treated with MMF at our institution (Victoria, Australia) for the past 11 years (2001-2012). RESULTS:We identified 26 patients, 14 female and 12 male. Nine patients (34.6%) had associated systemic conditions. All patients received prednisolone. MMF was used as a first-line steroid-sparing agent in 11 patients (42.3%), second-line in 14 (53.8%), and third-line in 1 (3.85%). The average duration of treatment was 12.1 months. Fourteen patients experienced side effects (53.8%), although most were mild (26.9%). One patient died after a sigmoid colon perforation (3.85%). Overall 22 patients demonstrated clinical improvement during MMF treatment (84.6%). Thirteen patients achieved complete ulcer healing (50%), 10 while taking MMF and 3 after ceasing it. LIMITATIONS:This is a retrospective study based on a single-center cohort. CONCLUSION:Our experience suggests that MMF is highly efficacious in PG together with prednisolone, or as part of combination therapy with other immunosuppressants.

journal_name

J Am Acad Dermatol

authors

Li J,Kelly R

doi

10.1016/j.jaad.2013.05.028

subject

Has Abstract

pub_date

2013-10-01 00:00:00

pages

565-9

issue

4

eissn

0190-9622

issn

1097-6787

pii

S0190-9622(13)00594-X

journal_volume

69

pub_type

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