Thomas, K. S., Ormerod, A. D., Craig, F., Greenlaw, N., Norrie, J., Mitchell, E., Mason, J. M., Johnston, G. A., Wahie, S. and Williams, H. C. (2016) Clinical outcomes and response of patients applying topical therapy for pyoderma gangrenosum: a prospective cohort study. Journal of the American Academy of Dermatology, 75(5), pp. 940-949. (doi: 10.1016/j.jaad.2016.06.016) (PMID:27502313)
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Abstract
Objective: We sought to estimate the effectiveness of topical therapies in the treatment of patients with PG. Methods: This 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 6 weeks. Secondary outcomes included the following: proportion healed by 6 months; time to healing; global assessment; inflammation; pain; quality of life; treatment failure; and recurrence. Results: Sixty-six patients (22-85 years of age) were enrolled. Clobetasol propionate 0.05% was the most commonly prescribed therapy. Overall, 28 of 66 (43.8%) ulcers healed by 6 months. The median time to healing was 145 days (95% confidence interval, 96 days to ∞). Initial ulcer size was a significant predictor of time to healing (hazard ratio, 0.94 [95% confidence interval, 0.88-1.00); P = .043). Four patients (15%) had a recurrence. Limitations Our study did not include a randomized comparator. Conclusion: Topical 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.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Greenlaw, Miss Nicola |
| Authors: | Thomas, K. S., Ormerod, A. D., Craig, F., Greenlaw, N., Norrie, J., Mitchell, E., Mason, J. M., Johnston, G. A., Wahie, S., and Williams, H. C. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre |
| Journal Name: | Journal of the American Academy of Dermatology |
| Publisher: | Elsevier |
| ISSN: | 0190-9622 |
| ISSN (Online): | 1097-6787 |
| Published Online: | 05 August 2016 |
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