Pyoderma Gangrenosis

[jnette, ASN, EMT-I]

Has anybody had any experience with this?

One of my HH patients has been dx'd with this. She has severe RA and OA and is waiting for a much needed hip replacement. Sadly, she is having to wait.. and wait.. and wait..until her many open ulcers heal up.

She continuously breaks out in new ulcers... and we have been treating these for many months. One WC specialist insisted on calling them "pressure ulcers" but they look nothing like pressure ulcers, plus she has one on her pubic area where there is no "pressure" from anything. Another one on her elbow,, the slightest bump or bruise and her skin breaks down into an actual "hole". These are taking forever to heal, truth be told, we are having NO success in getting these to close up.

First WC specialist was having us use the ol' Dakin's Solution WTDs. The second WC doc dx'd pyoderma gangrenosis and agreed to let us try Aquacell AG, but still no results.

This same patient had Sweet Syndrome a year or more ago, but they say this is not Sweet Syndrome this time.

Does anybody have any suggestions? We've been at this for MONTHS with no success at all.

MD started her on Prednisone two weeks ago as well, but even with this, no results.

I could sure use some input, suggestions, advice. I'd be ever so grateful for any tips or previous positive results. :)

Thanx in advance!

[oldiebutgoodie, RN]

Hi, Jnette,

I have heard of success with topical steroids. I even heard of success putting Flonase directly onto the lesions!

Also, I recently completed an internship for my CWON certification at a large university hospital, and they had successfully used Elidel cream for pyoderma.

http://www.elidel.com/index.jsp

Here is a very recent article I found on Pubmed about treating it with Etanercept, an anti-TNF alpha drug.

http://www.ncbi.nlm.nih.gov/pubmed/18358433?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

I think you have to work with docs who don't mind being a little adventurous.

Good luck,

Oldiebutgoodie

[jnette, ASN, EMT-I]

Wow... thank you, thank you, THANK YOU !!! :w00t:

Will definately run this by the spouse and the doc... hopefully they will let us try this!

You're the best !!! :icon_hug: