SciELO - Scientific Electronic Library Online

 
vol.20 issue3History of skin commitment in systemic sclerosisFlash pulmonary edema secondary to renal artery thrombosis (Pickering syndrome) for catastrophic antiphospholipid syndrome author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google

Share


Revista Colombiana de Reumatología

Print version ISSN 0121-8123

Abstract

SEGURA CHARRY, Juan Sebastián; JAIMES, Diego Alejandro  and  LONDONO, John Darío. Refractory pyoderma gangrenosum: Utility of combined therapy. Focus on benefits of hyperbaric therapy in its treatment. Rev.Colomb.Reumatol. [online]. 2013, vol.20, n.3, pp.171-176. ISSN 0121-8123.

Abstract Pyoderma gangrenosum is a type of neutrophilic dermatosis that has an idiopathic component, or can be associated with other underlying systemic pathologies. It is the result of an exaggerated response against specific and non specific stimuli. The first line of therapy are glucocorticoids (GC); however, in some patients, control of the pathology is not achieve with this treatment (local or systemic), and it is needed a step-up therapy going through several immuno-modulating treatments, biologic agents Anti - TNFα, and in refractory cases, the use of non conventional therapies such as Hyperbaric Oxygen Therapy (THBO). In this case, a previously healthy 42 year old man, debuts with an ulcerated lesion in his right lower limb, and he is initially treated with GC with poor response. He then required the use of several synthetic immune modulators without therapeutic efficacy. We opted to iniciate Anti-TNFα therapy obtaining therapeutic failure with the use of etanercept, infliximab, and adalimumab given in regular drug regimens. Finally, it is modify the frecuency of adalimumab to one dose per week without appropriate response; it is then added micofenolate mofetil, and fifty sessions of THBO, achieving successful control of this pathology.

Keywords : Pyoderma gangrenosum; Skin and connective tissue diseases; Hyperbaric oxygen therapy; Adalimumab; Etanercept; Infliximab.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )