کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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5648384 | 1587503 | 2016 | 10 صفحه PDF | دانلود رایگان |
BackgroundPyoderma gangrenosum (PG) is an uncommon dermatosis with a limited evidence base for treatment.ObjectiveWe sought to estimate the effectiveness of topical therapies in the treatment of patients with PG.MethodsThis was a prospective cohort study of UK secondary care patients with a clinical diagnosis of PG that was suitable for topical treatment (recruited between July 2009 and June 2012). Participants received topical therapy after normal clinical practice (primarily topical corticosteroids [classes I-III] and tacrolimus 0.03% or 0.1%). The primary outcome was speed of healing at 6Â weeks. Secondary outcomes included the following: proportion healed by 6Â months; time to healing; global assessment; inflammation; pain; quality of life; treatment failure; and recurrence.ResultsSixty-six patients (22-85Â years of age) were enrolled. Clobetasol propionate 0.05% was the most commonly prescribed therapy. Overall, 28 of 66 (43.8%) ulcers healed by 6Â months. The median time to healing was 145Â days (95% confidence interval, 96Â days to â). Initial ulcer size was a significant predictor of time to healing (hazard ratio, 0.94 [95% confidence interval, 0.88-1.00); PÂ =Â .043). Four patients (15%) had a recurrence.LimitationsOur study did not include a randomized comparator.ConclusionTopical therapy is potentially an effective first-line treatment for PG that avoids the possible side effects associated with systemic therapy. It remains unclear whether more severe disease will respond adequately to topical therapy alone.
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Journal: Journal of the American Academy of Dermatology - Volume 75, Issue 5, November 2016, Pages 940-949