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Review of 21 Cases

Janet H. Prystowsky, MD, PhD; Sidney N. Kahn, MB, PhD; Gerald S. Lazarus, MD

Arch Dermatol. 1989;125(1):57-64.

Abstract
• This article summarizes the management of 22 cases of pyoderma gangrenosum over the past four years at the hospital of the University of Pennsylvania, Philadelphia. Eighteen patients with pyoderma gangrenosum were studied using the most sensitive routine laboratory method for detection of monoclonal immunoglobulins, immunofixation electrophoresis. Four cases of IgA gammopathy were detected, confirming previous reports of the incidence of monoclonal gammopathy in pyoderma gangrenosum. High-dose glucocorticoid therapy (pulse therapy) is an effective treatment for some severe, refractory cases of pyoderma gangrenosum. Eight patients were treated with pulse therapy. Six responded favorably, and none had serious complications.

(Arch Dermatol 1989;125:57-64)

Author Affiliations
From the Departments of Dermatology (Drs Prystowsky and Lazarus) and Pathology and Laboratory Medicine (Dr Kahn), University of Pennsylvania, Philadelphia. Dr Prystowsky is currently with the Department of Dermatology, Columbia University College of Physicians and Surgeons, New York. Dr Kahn is currently with the Department of Pathology, St Luke's Hospital, Bethlehem, Pa.

Footnotes
Accepted for publication Aug 8, 1988.

Presented to the Pennsylvania Academy of Dermatology, Pittsburgh, Sept 20, 1986.

Reprint requests to Department of Dermatology, Columbia University College of Physicians and Surgeons, 630 W 168th St, New York, NY 10021 (Dr Prystowsky).

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