Author Affiliations: Department of Dermatology, Eberhard Karls University Tübingen, Tübingen, Germany (Drs Guenova, Walker, Adamczyk, Schaller, Hoetzenecker, and Biedermann, Mss Teske and Fehrenbacher, Mr Hoerber); Department of Dermatology, Brigham and Women's Hospital, Harvard Skin Disease Research Center, Boston, Massachusetts (Drs Guenova and Hoetzenecker).
In response to Kluger's comments on our use of ustekinumab in the treatment of PG,1 we would like to draw attention to several important issues regarding this treatment and its indication in our patient and in general. We agree with Kluger that there is the highest medical need for new and effective treatment options for PG. Various drug regimens have been implemented in the treatment of PG without any of them being effective at all times in all patients. This indicates that different cases of PG as well as the varying efficacy of treatments are likely based at least partly on different disease mechanisms. In addition, many of the drugs used to treat PG (eg, high-dose systemic corticosteroids, cyclosporine, mycophenolate mofetil, thalidomide, cyclophosphamide, infliximab, etanercept) have serious adverse event profiles, increasing the need to choose the right treatment for each patient.2
Guenova E, Walker F, Teske A, Fehrenbacher B, Hoerber S, Adamczyk A, Schaller M, Hoetzenecker W, Biedermann T. Ustekinumab for Pyoderma Gangrenosum—Reply. Arch Dermatol. 2012;148(5):656. doi:10.1001/archdermatol.2012.89