Clinical factors influencing the response to intravenous immunoglobulin treatment in cases of treatment-resistant pyoderma gangrenosum.
J Dermatolog Treat
; 31(7): 723-726, 2020 Nov.
Article
in En
| MEDLINE
| ID: mdl-30998080
ABSTRACT
Background:
Pyoderma gangrenosum (PG) is a neutrophilic disorder which classically presents as chronic, painful ulcers on the lower extremities. There is evidence supporting a potential role for intravenous immunoglobulin (IVIG) as adjuvant therapy for treatment-resistant cases; however, it is unclear which patients will most benefit from this modality of treatment - an especially important consideration given the cost per infusion ($5000-$10,000). Thus, we sought to identify the clinical characteristics of patients with refractory PG lesions who demonstrated complete healing when IVIG was incorporated into the therapeutic plan.Methods:
We performed a literature search of PubMed/MEDLINE and Embase using the keywords 'pyoderma gangrenosum' and 'IVIG'. We also added four institutional cases. Descriptive statistics were used to analyze the data. Significance was set at p < .05.Results:
We discovered a total of 45 cases. Twenty-three patients with treatment-resistant PG had complete healing, 22 had partial or unhealed PG ulcers. Patients with one ulcer were 4.1 (95% CI 1.1-18.5) times more likely to achieve complete healing than patients with more than one ulcer, when IVIG was added (p = .041).Conclusion:
There is increased efficacy of IVIG as a treatment for patients with a solitary treatment-resistant PG lesion compared to patients with multiple refractory lesions.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Immunoglobulins, Intravenous
/
Pyoderma Gangrenosum
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Dermatolog Treat
Journal subject:
DERMATOLOGIA
Year:
2020
Document type:
Article
Affiliation country:
United States