Mycophenolate mofetil as adjunctive therapy to corticosteroids for the treatment of pyoderma gangrenosum: a case series and literature review

Pyoderma gangrenosum is a rare neutrophilic dermatosis that commonly treated with systemic corticosteroids; however, their potent side effects may warrant tapering, and non-steroidal immunosuppressants help maintain or bolster disease clearance during weaning. Although cyclosporine regarded as favorable corticosteroid-sparing agent, it associated several effects, such renal toxicity hypertension, limit its feasibility. Mycophenolate mofetil well-tolerated alternative limited data. Institutional review board approval was obtained to patients from single institution who received mycophenolate for pyoderma between January 1, 2010, December 31, 2019. A systematic MEDLINE (PubMed) performed of articles containing linked keywords: “mycophenolate mofetil” “pyoderma gangrenosum”. Patient demographics, presentation details, treatment regimen characteristics were recorded. Fourteen our concomitantly prednisone. Ninety-three percent achieved improvement within 12 months (mean 4.5 months), including five experienced complete healing. Outcomes in literature comparable; 77% either improved maintained mofetil. Greater than 80% total healing adequate control at median dose 2000 mg daily. The most common myelosuppression gastrointestinal upset, which both seen 18% patients. this study subject publication bias, appears be an efficacious adjunctive therapy option gangrenosum.