Treatment of pyoderma gangrenosum is aimed at reducing swelling, controlling pain and helping skin sores heal. Medicines are the most common treatment. Treatment also might involve wound care and surgery. Your treatment depends on your health, how many sores you have, how deep they are and how fast they’re growing.
Some people respond well to treatment with a combination of medicine taken by mouth, creams and injections. Sores can take weeks or months to heal, and it’s common for new ones to develop.
Medicines
- Corticosteroids. The most common treatment for pyoderma gangrenosum is daily doses of corticosteroids. These drugs may be applied to the skin, injected into the wound or taken by mouth. The pill form is called prednisone. Using corticosteroids for a long time or in high doses may cause severe side effects. To avoid these side effects, steroids may be used only for short periods of time to control the sores. And other medicines that target the immune system may be used long term to control the disease. These are called steroid-sparing medicines or steroid-sparing drugs.
- Medicines that target the immune system. Some medicines can stop your immune system from attacking healthy tissues. Examples are the the steroid-sparing medicines cyclosporine, mycophenolate (Cellcept), immunoglobulins, dapsone, infliximab (Remicade) and tacrolimus (Protopic). Tacrolimus is a type of medicine called a calcineurin inhibitor. Steroid-sparing medicines might be applied to the wounds, injected or taken by mouth. These medicines also can have severe side effects.
- Pain medicine. Depending on the extent of your wounds, you may benefit from pain medicine, especially when your dressings are being changed.
Wound care
In addition to applying medicine to your wounds, a healthcare professional may cover them with a moist nonstick dressing and, perhaps, an elasticized wrap. You may be asked to keep the affected area raised. Follow instructions you receive for wound care.
Surgery
Because pyoderma gangrenosum can be made worse by cuts to the skin, surgery to remove dead tissue is not usually considered a good treatment option. Trauma to the skin may worsen existing sores or bring on new ones.
If sores are large and aren’t healing, a skin graft may be an option. In this procedure, the surgeon attaches a piece of skin from somewhere else on your body over the open sores.