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Diagnosed with pyoderma gangrenoseum after dealing with small burn. Infected with MSRA. Failed skin grafts. Wounds are painful. Help?

Was diagnosed with pyoderma gangrenoseum after dealing with a small burn on my right lower fore arm that became infected with MARSA and had 4 failed skin grafts. The burn was very small but soon grew into this large open wound from the elbow where the burn was and has now gone all the way down on my hand. I am a chronic anemic and low iron count for which I have had to have blood transfusion and iron infusions every few months. MRI has shown a nodule on my liver, and enlarged spleen and cysts on both kidneys. The doctors are now going to start me on cyclosporine because I am allergic to steroids. Does this seem like a good option as the drug therapy to try. The wound is extremely painful and drains large amounts on a daily basis.
Asked On : Sat, 12 Oct 2013
Answers:  1 Views:  27
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Dermatologist 's  Response
Jan 2014
hi. Pyoderma gangrenosum is one of the neutrophilic dermatosis. It usually presents as a non-healing ulcer with undermined edges and keeps on expanding.

First-line therapy pyoderma gangrenosum is systemic treatment by corticosteroids and cyclosporine.
Topical application of Clobetasol, Mupirocin, and Gentamicin alternated with Tacrolimus can be effective.

Grafting is not recommended due to tissue necrosis.

If ineffective, alternative therapeutic procedures include systemic treatment with corticosteroids and mycophenolate mofetil; mycophenolate mofetil and cyclosporine; tacrolimus; thalidomide; infliximab; or plasmapheresis
Answered: Fri, 15 Nov 2013
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