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November 1991

Cyclosporine Treatment of Severe Recalcitrant Pyoderma Gangrenosum in a Patient With Takayasu's Arteritis

Author Affiliations

Department of Dermatology Stanford University Medical Stanford, CA 94305; Division of Dermatology; Section of Rheumatology King Faisal Specialist Hospital PO Box 3354 Riyadh, Kingdom of Saudi Arabia 11211

Arch Dermatol. 1991;127(11):1731-1732. doi:10.1001/archderm.1991.01680100135027

To the Editor.—  We describe a patient with Takayasu's arteritis (TA) and a 2-year history of severe, recalcitrant pyoderma gangrenosum (PG) that was successfully treated with cyclosporine.

Report of a Case.—  A 30-year-old woman from Saudi Arabia presented with exquisitely tender boggy erythematous erosions with purulent exudate. There were 10 lesions on the lower extremities (Figure, left), two measuring greater than 20 cm. Due to pain, she had been nonambulatory for 3 months.Her disease began during pregnancy with a nonhealing abdominal ulcer, followed rapidly by development of multiple leg ulcers. She received topical antibiotics, potassium permanganate soaks, and oral prednisone. Due to poor healing, dapsone therapy was added, but without response. She then sought treatment in Texas, where she was given methylprednisolone injections, minocycline, intralesional triamcinolone, dressings (Duoderm, Convatec Inc, Princeton, NJ), mupirocin, and 3 months of oral cyclophosphamide. Peripheral extension continued, and chlorambucil therapy was begun.

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