PMID- 32291879
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20210514
IS  - 1529-8019 (Electronic)
IS  - 1396-0296 (Linking)
VI  - 33
IP  - 3
DP  - 2020 May
TI  - PG-TIME: A practical approach to the clinical management of pyoderma gangrenosum.
PG  - e13412
LID - 10.1111/dth.13412 [doi]
AB  - Pyoderma gangrenosum (PG) is a neutrophilic dermatosis which may be rapidly 
      progressive. Standard guidelines for local treatment are lacking. Through our 
      experience, we suggested a local treatment algorithm based on the tissue, 
      infection, moisture balance, and epithelization (TIME) concept. The clinical and 
      histopathological features of 52 patients with PG, the duration, and the 
      evolution of the lesions were retrospectively evaluated. Systemic therapies, 
      local treatments, and standard wound treatments were reported. We observed 
      ulcerative PG in the majority of the patients (82.6%), followed by the pustular 
      form (9.6%), the peristomal type (3.8%), the vegetative form (1.9%), and the 
      bullous type (1.9%). The lower leg was the most commonly area affected (90.4% of 
      cases). Pathergy was reported in 15.3% of cases. The first-line treatment was the 
      use of oral glucocorticosteroids (GCSs). We observed healing after 3 weeks of GCS 
      in 17.3% of cases. In 25% of all cases, we obtained complete healing with 
      long-term low doses (<0.5 mg/kg) of GCS in the range of 2 to 6 months. We used 
      second-line treatments in 57.6% of patients. Local, systemic treatment, and 
      correct wound management can be associated with better clinical results. We 
      suggest a new local therapeutic algorithm in both the inflammatory and 
      noninflammatory healing phases.
CI  - (c) 2020 Wiley Periodicals LLC.
FAU - Janowska, Agata
AU  - Janowska A
AUID- ORCID: 0000-0002-2271-3859
AD  - Department of Dermatology, University of Pisa, Pisa, Italy.
FAU - Oranges, Teresa
AU  - Oranges T
AD  - Department of Dermatology, University of Pisa, Pisa, Italy.
AD  - Department of Health Sciences, Anna Meyer Children University Hospital, 
      University of Florence, Florence, Italy.
FAU - Fissi, Alba
AU  - Fissi A
AD  - Department of Dermatology, University of Pisa, Pisa, Italy.
FAU - Davini, Giulia
AU  - Davini G
AD  - Department of Dermatology, University of Pisa, Pisa, Italy.
FAU - Romanelli, Marco
AU  - Romanelli M
AD  - Department of Dermatology, University of Pisa, Pisa, Italy.
FAU - Dini, Valentina
AU  - Dini V
AD  - Department of Dermatology, University of Pisa, Pisa, Italy.
LA  - eng
PT  - Journal Article
DEP - 20200505
PL  - United States
TA  - Dermatol Ther
JT  - Dermatologic therapy
JID - 9700070
SB  - IM
MH  - Humans
MH  - *Pyoderma Gangrenosum/diagnosis/drug therapy
MH  - Retrospective Studies
MH  - Wound Healing
OTO - NOTNLM
OT  - TIME
OT  - pyoderma gangrenosum
OT  - wound bed preparation
OT  - wound healing
EDAT- 2020/04/16 06:00
MHDA- 2021/05/15 06:00
CRDT- 2020/04/16 06:00
PHST- 2019/11/21 00:00 [received]
PHST- 2020/04/03 00:00 [revised]
PHST- 2020/04/09 00:00 [accepted]
PHST- 2020/04/16 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2020/04/16 06:00 [entrez]
AID - 10.1111/dth.13412 [doi]
PST - ppublish
SO  - Dermatol Ther. 2020 May;33(3):e13412. doi: 10.1111/dth.13412. Epub 2020 May 5.