Pyoderma Vegetans Treatment & Management

Updated: Mar 26, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Treatment

Medical Care

No standardized treatment plan is available for pyoderma vegetans (PV), although antibiotic treatment has often been used with variable results. [40] Other options include curettage and topical therapies, including aluminium subacetate soaks plus attention to any underlying systemic illness. [41]

Topical wound care with copper sulfate or aluminum subacetate dressings and intravenous antibiotics successfully treated 5 of 7 patients with pyoderma vegetans. [2]

Topical aluminum acetate soaks with intravenous ceftriaxone had moderate success at clearing pyoderma vegetans in another patient. [20]

Over a course of 2 months, the application of zinc oxide along with the intralesional injection of corticosteroids completely cleared lesions on the perianal area of 1 patient. [39]

A vegetating lesion on the dorsum of a patient's hand was completely cleared with 4 weeks of 2 g of ampicillin daily and x-ray irradiation. [32]

In the treatment of 1 patient whose lesions were refractory to antibiotic treatment, topical application of disodium chromoglycate, which is used for the management of chronic leg ulcers [42] and pyoderma gangrenosum, [43] induced the healing of lesions. [7, 44]

Ichimiya et al reported successful treatment with etretinate and systemic steroids. [45]

A patient with pyoderma vegetans attributed to Candida albicans was treated successfully with itraconazole. [46]

Other options include low-dose sulfasalazine [47] or infusions of 20% human albumin (100 mL) for 5 days, followed by methylprednisolone (40 mg/d) for a month. [48]

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Surgical Care

Antibiotic treatment has been successfully supplemented with laser debridement or curettage to clear lesions. [49] Surgery is a therapeutic option when conservative treatment proves ineffective. Complete excision and skin grafting may be performed with a good postoperative result. [50]

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