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Pyoderma gangrenosum: Treatment and prognosis

Courtney Schadt, MD
Section Editor
Jeffrey Callen, MD, FACP, FAAD
Deputy Editor
Abena O Ofori, MD


Pyoderma gangrenosum (PG) is an uncommon inflammatory and ulcerative skin disorder characterized histopathologically by the accumulation of neutrophils in the skin. The most common presentation of PG is the rapid development of one or more painful, purulent ulcer with undermined borders on sites of normal or traumatized skin.

Although multiple local and systemic therapies have been utilized for PG, high quality efficacy studies are lacking for most interventions. Topical and systemic corticosteroids, topical tacrolimus, and systemic cyclosporine are among the most commonly utilized pharmacologic agents.

The management and prognosis of PG will be reviewed here. The pathogenesis, clinical features, and diagnosis of PG are reviewed separately. (See "Pyoderma gangrenosum: Pathogenesis, clinical features, and diagnosis".)


The careful exclusion of other disorders that may cause cutaneous ulceration is an important first step in the management of lesions that appear consistent with pyoderma gangrenosum (PG). This is of particular importance since certain therapies utilized for PG can be ineffective or harmful in other diseases. (See "Pyoderma gangrenosum: Pathogenesis, clinical features, and diagnosis", section on 'Diagnosis' and "Pyoderma gangrenosum: Pathogenesis, clinical features, and diagnosis", section on 'Differential diagnosis'.)

As a result of the paucity of data on interventions for PG, definitive guidelines for patient management are lacking. The approach to the treatment of PG is primarily guided by small uncontrolled studies and clinical experience. In general, patients are managed with a combination of topical and/or systemic therapies that suppress the inflammatory process and wound care measures that optimize the environment for wound healing. Although initial signs of improvement may be evident within days of the start of treatment, weeks to months are often required to achieve complete ulcer healing [1,2].

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Literature review current through: Dec 2017. | This topic last updated: Aug 07, 2017.
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  1. Bennett ML, Jackson JM, Jorizzo JL, et al. Pyoderma gangrenosum. A comparison of typical and atypical forms with an emphasis on time to remission. Case review of 86 patients from 2 institutions. Medicine (Baltimore) 2000; 79:37.
  2. Powell FC, Hackett BC, Wallach D. Pyoderma gangrenosum. In: Fitzpatrick's Dermatology in General Medicine, 8th ed, Goldsmith LA, Katz SI, Gilchrest BA, et al (Eds), McGraw-Hill Companies, Inc., New York 2012. Vol 1, p.371.
  3. Ahronowitz I, Harp J, Shinkai K. Etiology and management of pyoderma gangrenosum: a comprehensive review. Am J Clin Dermatol 2012; 13:191.
  4. Miller J, Yentzer BA, Clark A, et al. Pyoderma gangrenosum: a review and update on new therapies. J Am Acad Dermatol 2010; 62:646.
  5. Thomas CY Jr, Crouch JA, Guastello J. Hyperbaric oxygen therapy for pyoderma gangrenosum. Arch Dermatol 1974; 110:445.
  6. Davis JC, Landeen JM, Levine RA. Pyoderma gangrenosum: skin grafting after preparation with hyperbaric oxygen. Plast Reconstr Surg 1987; 79:200.
  7. Mazokopakis EE, Kofteridis DP, Pateromihelaki AT, et al. Improvement of ulcerative pyoderma gangrenosum with hyperbaric oxygen therapy. Dermatol Ther 2011; 24:134.
  8. Alam M, Grossman ME, Schneiderman PI, et al. Surgical management of pyoderma gangrenosum: case report and review. Dermatol Surg 2000; 26:1063.
  9. Barańska-Rybak W, Kakol M, Naesstrom M, et al. A retrospective study of 12 cases of pyoderma gangrenosum: why we should avoid surgical intervention and what therapy to apply. Am Surg 2011; 77:1644.
  10. Reichrath J, Bens G, Bonowitz A, Tilgen W. Treatment recommendations for pyoderma gangrenosum: an evidence-based review of the literature based on more than 350 patients. J Am Acad Dermatol 2005; 53:273.
  11. Callen JP, Jackson JM. Pyoderma gangrenosum: an update. Rheum Dis Clin North Am 2007; 33:787.
  12. Kim DW, Lee BI, Park SH. Accelerated healing of pyoderma gangrenosum in Behçet patient treated with cyclosporine and split thickness skin graft. Ann Plast Surg 2008; 61:552.
  13. Classen DA, Thomson C. Free flap coverage of pyoderma gangrenosum leg ulcers. J Cutan Med Surg 2002; 6:327.
  14. Zakhireh M, Rockwell WB, Fryer RH. Stabilization of pyoderma gangrenosum ulcer with oral cyclosporine prior to skin grafting. Plast Reconstr Surg 2004; 113:1417.
  15. Rozen SM, Nahabedian MY, Manson PN. Management strategies for pyoderma gangrenosum: case studies and review of literature. Ann Plast Surg 2001; 47:310.
  16. Pichler M, Larcher L, Holzer M, et al. Surgical treatment of pyoderma gangrenosum with negative pressure wound therapy and split thickness skin grafting under adequate immunosuppression is a valuable treatment option: Case series of 15 patients. J Am Acad Dermatol 2016; 74:760.
  17. Wollina U, Karamfilov T. Treatment of recalcitrant ulcers in pyoderma gangrenosum with mycophenolate mofetil and autologous keratinocyte transplantation on a hyaluronic acid matrix. J Eur Acad Dermatol Venereol 2000; 14:187.
  18. Toyozawa S, Yamamoto Y, Nishide T, et al. Case report: a case of pyoderma gangrenosum with intractable leg ulcers treated by allogeneic cultured dermal substitutes. Dermatol Online J 2008; 14:17.
  19. Barbosa NS, Tolkachjov SN, El-Azhary RA, et al. Clinical features, causes, treatments, and outcomes of peristomal pyoderma gangrenosum (PPG) in 44 patients: The Mayo Clinic experience, 1996 through 2013. J Am Acad Dermatol 2016; 75:931.
  20. Le Cleach L, Moguelet P, Perrin P, Chosidow O. Is topical monotherapy effective for localized pyoderma gangrenosum? Arch Dermatol 2011; 147:101.
  21. Thomas KS, Ormerod AD, Craig FE, et al. Clinical outcomes and response of patients applying topical therapy for pyoderma gangrenosum: A prospective cohort study. J Am Acad Dermatol 2016; 75:940.
  22. Lyon CC, Stapleton M, Smith AJ, et al. Topical tacrolimus in the management of peristomal pyoderma gangrenosum. J Dermatolog Treat 2001; 12:13.
  23. Hughes AP, Jackson JM, Callen JP. Clinical features and treatment of peristomal pyoderma gangrenosum. JAMA 2000; 284:1546.
  24. Dohan FC. Schizophrenia and neuroactive peptides from food. Lancet 1979; 1:1031.
  25. Jennings JL. Pyoderma gangrenosum: successful treatment with intralesional steroids. J Am Acad Dermatol 1983; 9:575.
  26. Moschella SL. Pyoderma gangrenosum. A patient successfully treated with intralesional injections of steroid. Arch Dermatol 1967; 95:121.
  27. Prajapati V, Man J, Brassard A. Pyoderma gangrenosum: common pitfalls in management and a stepwise, evidence-based, therapeutic approach. J Cutan Med Surg 2009; 13 Suppl 1:S2.
  28. Larsen CG, Thyssen JP. Pustular penile pyoderma gangrenosum successfully treated with topical tacrolimus ointment. Acta Derm Venereol 2012; 92:104.
  29. Altieri M, Vaziri K, Orkin BA. Topical tacrolimus for parastomal pyoderma gangrenosum: a report of two cases. Ostomy Wound Manage 2010; 56:56.
  30. Marzano AV, Trevisan V, Lazzari R, Crosti C. Topical tacrolimus for the treatment of localized, idiopathic, newly diagnosed pyoderma gangrenosum. J Dermatolog Treat 2010; 21:140.
  31. Kimble RM, Tickler AK, Nicholls VS, Cleghorn G. Successful topical tacrolimus (FK506) therapy in a child with pyoderma gangrenosum. J Pediatr Gastroenterol Nutr 2002; 34:555.
  32. Bellini V, Simonetti S, Lisi P. Successful treatment of severe pyoderma gangrenosum with pimecrolimus cream 1%. J Eur Acad Dermatol Venereol 2008; 22:113.
  33. Mrowietz U, Christophers E. Clearing of pyoderma gangrenosum by intralesional cyclosporin A. Br J Dermatol 1991; 125:499.
  34. Wenzel J, Gerdsen R, Phillipp-Dormston W, et al. Topical treatment of pyoderma gangraenosum. Dermatology 2002; 205:221.
  35. Theissen U, Luger TA, Schwarz T. [Successful topical administration of cyclosporin A in pyoderma gangraenosum]. Hautarzt 1996; 47:132.
  36. Azizan NZ, Gangaram HB, Hussein SH. A novel therapy for the treatment of pyoderma gangrenosum. Med J Malaysia 2008; 63:51.
  37. Binus AM, Qureshi AA, Li VW, Winterfield LS. Pyoderma gangrenosum: a retrospective review of patient characteristics, comorbidities and therapy in 103 patients. Br J Dermatol 2011; 165:1244.
  38. Ormerod AD, Thomas KS, Craig FE, et al. Comparison of the two most commonly used treatments for pyoderma gangrenosum: results of the STOP GAP randomised controlled trial. BMJ 2015; 350:h2958.
  39. Prystowsky JH, Kahn SN, Lazarus GS. Present status of pyoderma gangrenosum. Review of 21 cases. Arch Dermatol 1989; 125:57.
  40. Yamauchi T, Ishida K, Iwashima Y, et al. Successful treatment of pyoderma gangrenosum that developed in a patient with myelodysplastic syndrome. J Infect Chemother 2003; 9:268.
  41. Aseni P, Di Sandro S, Mihaylov P, et al. Atypical presentation of pioderma gangrenosum complicating ulcerative colitis: rapid disappearance with methylprednisolone. World J Gastroenterol 2008; 14:5471.
  42. Chow RK, Ho VC. Treatment of pyoderma gangrenosum. J Am Acad Dermatol 1996; 34:1047.
  43. von den Driesch P. Pyoderma gangrenosum: a report of 44 cases with follow-up. Br J Dermatol 1997; 137:1000.
  44. Vidal D, Puig L, Gilaberte M, Alomar A. Review of 26 cases of classical pyoderma gangrenosum: clinical and therapeutic features. J Dermatolog Treat 2004; 15:146.
  45. Hasselmann DO, Bens G, Tilgen W, Reichrath J. Pyoderma gangrenosum: clinical presentation and outcome in 18 cases and review of the literature. J Dtsch Dermatol Ges 2007; 5:560.
  46. Turner RB, Emer JJ, Weill M, et al. Rapid resolution of pyoderma gangrenosum after treatment with intravenous cyclosporine. J Am Acad Dermatol 2010; 63:e72.
  47. Brooklyn TN, Dunnill MG, Shetty A, et al. Infliximab for the treatment of pyoderma gangrenosum: a randomised, double blind, placebo controlled trial. Gut 2006; 55:505.
  48. Mooij JE, van Rappard DC, Mekkes JR. Six patients with pyoderma gangrenosum successfully treated with infliximab. Int J Dermatol 2013; 52:1418.
  49. Regueiro M, Valentine J, Plevy S, et al. Infliximab for treatment of pyoderma gangrenosum associated with inflammatory bowel disease. Am J Gastroenterol 2003; 98:1821.
  50. Adişen E, Oztaş M, Gürer MA. Treatment of idiopathic pyoderma gangrenosum with infliximab: induction dosing regimen or on-demand therapy? Dermatology 2008; 216:163.
  51. Hubbard VG, Friedmann AC, Goldsmith P. Systemic pyoderma gangrenosum responding to infliximab and adalimumab. Br J Dermatol 2005; 152:1059.
  52. Alkhouri N, Hupertz V, Mahajan L. Adalimumab treatment for peristomal pyoderma gangrenosum associated with Crohn's disease. Inflamm Bowel Dis 2009; 15:803.
  53. Reddick CL, Singh MN, Chalmers RJ. Successful treatment of superficial pyoderma gangrenosum associated with hidradenitis suppurativa with adalimumab. Dermatol Online J 2010; 16:15.
  54. Cariñanos I, Acosta MB, Domènech E. Adalimumab for pyoderma gangrenosum associated with inflammatory bowel disease. Inflamm Bowel Dis 2011; 17:E153.
  55. Charles CA, Leon A, Banta MR, Kirsner RS. Etanercept for the treatment of refractory pyoderma gangrenosum: a brief series. Int J Dermatol 2007; 46:1095.
  56. Roy DB, Conte ET, Cohen DJ. The treatment of pyoderma gangrenosum using etanercept. J Am Acad Dermatol 2006; 54:S128.
  57. Nousari HC, Lynch W, Anhalt GJ, Petri M. The effectiveness of mycophenolate mofetil in refractory pyoderma gangrenosum. Arch Dermatol 1998; 134:1509.
  58. Gilmour E, Stewart DG. Severe recalcitrant pyoderma gangrenosum responding to a combination of mycophenolate mofetil with cyclosporin and complicated by a mononeuritis. Br J Dermatol 2001; 144:397.
  59. Daniels NH, Callen JP. Mycophenolate mofetil is an effective treatment for peristomal pyoderma gangrenosum. Arch Dermatol 2004; 140:1427.
  60. Eaton PA, Callen JP. Mycophenolate mofetil as therapy for pyoderma gangrenosum. Arch Dermatol 2009; 145:781.
  61. Li J, Kelly R. Treatment of pyoderma gangrenosum with mycophenolate mofetil as a steroid-sparing agent. J Am Acad Dermatol 2013; 69:565.
  62. Teitel AD. Treatment of pyoderma gangrenosum with methotrexate. Cutis 1996; 57:326.
  63. Sardar P, Guha P, Das NK, et al. Ulcerative pyoderma gangrenosum in mixed connective tissue disorder: a rare association and role of azathioprine in the management. Indian J Dermatol 2011; 56:600.
  64. Schmidt C, Wittig BM, Moser C, et al. Cyclophosphamide pulse therapy followed by azathioprine or methotrexate induces long-term remission in patients with steroid-refractory Crohn's disease. Aliment Pharmacol Ther 2006; 24:343.
  65. Fukuhara K, Urano Y, Kimura S, et al. Pyoderma gangrenosum with rheumatoid arthritis and pulmonary aseptic abscess responding to treatment with dapsone. Br J Dermatol 1998; 139:556.
  66. Teasley LA, Foster CS, Baltatzis S. Sclerokeratitis and facial skin lesions: a case report of pyoderma gangrenosum and its response to dapsone therapy. Cornea 2007; 26:215.
  67. Brown RE, Lay L, Graham D. Bilateral pyoderma gangrenosum of the hand: treatment with dapsone. J Hand Surg Br 1993; 18:119.
  68. Galun E, Flugelman MY, Rachmilewitz D. Pyoderma gangrenosum complicating ulcerative colitis: successful treatment with methylprednisolone pulse therapy and dapsone. Am J Gastroenterol 1986; 81:988.
  69. Farrell AM, Black MM, Bracka A, Bunker CB. Pyoderma gangrenosum of the penis. Br J Dermatol 1998; 138:337.
  70. Shenefelt PD. Pyoderma gangrenosum associated with cystic acne and hidradenitis suppurativa controlled by adding minocycline and sulfasalazine to the treatment regimen. Cutis 1996; 57:315.
  71. Boulinguez S, Bernard P, Bedane C, et al. Pyoderma gangrenosum complicating Cogan's syndrome. Clin Exp Dermatol 1998; 23:286.
  72. Langan SM, Powell FC. Vegetative pyoderma gangrenosum: a report of two new cases and a review of the literature. Int J Dermatol 2005; 44:623.
  73. Vandevyvere K, Luyten FP, Verschueren P, et al. Pyoderma gangrenosum developing during therapy with TNF-alpha antagonists in a patient with rheumatoid arthritis. Clin Rheumatol 2007; 26:2205.
  74. Sachs D, Su L, Dlugosz A. Verrucous annular ulcerated hip plaques. Diagnosis: superficial granulomatous pyoderma form of pyoderma gangrenosum. Arch Dermatol 2000; 136:1263.
  75. Miralles ES, Nuñez M, Pérez B, Ledo A. Minocycline hydrochloride hyperpigmentation complicating treatment of pyoderma gangrenosum. J Dermatol 1994; 21:965.
  76. Reynolds NJ, Peachey RD. Response of atypical bullous pyoderma gangrenosum to oral minocycline hydrochloride and topical steroids. Acta Derm Venereol 1990; 70:538.
  77. Davies MG, Piper S. Pyoderma gangrenosum: successful treatment with minocycline. Clin Exp Dermatol 1981; 6:219.
  78. Lynch WS, Bergfeld WF. Pyoderma gangrenosum responsive to minocycline hydrochloride. Cutis 1978; 21:535.
  79. Song H, Lahood N, Mostaghimi A. Intravenous immunoglobulin as adjunct therapy for refractory pyoderma gangrenosum: systematic review of cases and case series. Br J Dermatol 2017.
  80. Reynoso-von Drateln C, Perla-Navarro AV, Gamez-Nava JI, et al. Intravenous cyclophosphamide pulses in pyoderma gangrenosum: an open trial. J Rheumatol 1997; 24:689.
  81. Zonana-Nacach A, Jiménez-Balderas FJ, Martínez-Osuna P, Mintz G. Intravenous cyclophosphamide pulses in the treatment of pyoderma gangrenosum associated with rheumatoid arthritis: report of 2 cases and review of the literature. J Rheumatol 1994; 21:1352.
  82. Kaminska R, Ikäheimo R, Hollmen A. Plasmapheresis and cyclophosphamide as successful treatments for pyoderma gangrenosum. Clin Exp Dermatol 1999; 24:81.
  83. Burruss JB, Farmer ER, Callen JP. Chlorambucil is an effective corticosteroid-sparing agent for recalcitrant pyoderma gangrenosum. J Am Acad Dermatol 1996; 35:720.
  84. Callen JP, Case JD, Sager D. Chlorambucil--an effective corticosteroid-sparing therapy for pyoderma gangrenosum. J Am Acad Dermatol 1989; 21:515.
  85. Resnik BI, Rendon M, Kerdel FA. Successful treatment of aggressive pyoderma gangrenosum with pulse steroids and chlorambucil. J Am Acad Dermatol 1992; 27:635.
  86. de Cock KM, Thorne MG. The treatment of pyoderma gangrenosum with sodium cromoglycate. Br J Dermatol 1980; 102:231.
  87. Tamir A, Landau M, Brenner S. Topical treatment with 1% sodium cromoglycate in pyoderma gangrenosum. Dermatology 1996; 192:252.
  88. Patel GK, Rhodes JR, Evans B, Holt PJ. Successful treatment of pyoderma gangrenosum with topical 0.5% nicotine cream. J Dermatolog Treat 2004; 15:122.
  89. Wolf R. Nicotine for pyoderma gangrenosum. Arch Dermatol 1998; 134:1071.
  90. Kanekura T, Kanzaki T. Successful treatment of pyoderma gangrenosum with nicotine chewing gum. J Dermatol 1995; 22:704.
  91. Nguyen LQ, Weiner J. Treatment of pyoderma gangrenosum with benzoyl peroxide. Cutis 1977; 19:842.
  92. Vereecken P, Wautrecht JC, De Dobbeleer G, Heenen M. A case of pyoderma gangrenosum stabilized with lymecycline, topical benzoyl peroxide and treated by autograft. Dermatology 1997; 195:50.
  93. Sanders CJ, Hulsmans RF. Successful treatment of pyoderma gangrenosum with topical 5-aminosalicylic acid. Cutis 1993; 51:262.
  94. Tsele E, Yu RC, Chu AC. Pyoderma gangrenosum--response to topical nitrogen mustard. Clin Exp Dermatol 1992; 17:437.
  95. Braun-Falco M, Stock K, Ring J, Hein R. Topical platelet-derived growth factor accelerates healing of myelodysplastic syndrome-associated pyoderma gangrenosum. Br J Dermatol 2002; 147:829.
  96. Freedman BM, Oplinger EH. Use of becaplermin in progressive limb-threatening pyoderma gangrenosum. Adv Skin Wound Care 2002; 15:180.
  97. Mensing H. Clofazimine in dermatitis ulcerosa (pyoderma gangrenosum). Open clinical trial. Dermatologica 1988; 177:232.
  98. Paolini O, Hébuterne X, Flory P, et al. Treatment of pyoderma gangrenosum with colchicine. Lancet 1995; 345:1057.
  99. Kontochristopoulos GJ, Stavropoulos PG, Gregoriou S, Zakopoulou N. Treatment of Pyoderma gangrenosum with low-dose colchicine. Dermatology 2004; 209:233.
  100. Smith JB, Shenefelt PD, Soto O, Valeriano J. Pyoderma gangrenosum in a patient with cryoglobulinemia and hepatitis C successfully treated with interferon alfa. J Am Acad Dermatol 1996; 34:901.
  101. Jones RR, Kobza Black A, Donaghy M, et al. Defective monocyte function in pyoderma gangrenosum with IgG kappa paraproteinaemia. Clin Exp Immunol 1983; 52:685.
  102. East-Innis A, Desnoes R, Thame K, et al. Pyoderma gangrenosum associated with osteomyelitis in a paediatric patient: a case report. West Indian Med J 2005; 54:207.
  103. Sheldon DG, Sawchuk LL, Kozarek RA, Thirlby RC. Twenty cases of peristomal pyoderma gangrenosum: diagnostic implications and management. Arch Surg 2000; 135:564.
  104. Richardson JB, Callen JP. Pyoderma gangrenosum treated successfully with potassium iodide. J Am Acad Dermatol 1993; 28:1005.
  105. Jolles S, Niclasse S, Benson E. Combination oral and topical tacrolimus in therapy-resistant pyoderma gangrenosum. Br J Dermatol 1999; 140:564.
  106. Kim TH, Oh SY, Myung SC. Pyoderma gangranosum of the penis. J Korean Med Sci 2009; 24:1200.
  107. Federman GL, Federman DG. Recalcitrant pyoderma gangrenosum treated with thalidomide. Mayo Clin Proc 2000; 75:842.
  108. Guenova E, Teske A, Fehrenbacher B, et al. Interleukin 23 expression in pyoderma gangrenosum and targeted therapy with ustekinumab. Arch Dermatol 2011; 147:1203.
  109. Fahmy M, Ramamoorthy S, Hata T, Sandborn WJ. Ustekinumab for peristomal pyoderma gangrenosum. Am J Gastroenterol 2012; 107:794.
  110. Kolios AG, Maul JT, Meier B, et al. Canakinumab in adults with steroid-refractory pyoderma gangrenosum. Br J Dermatol 2015; 173:1216.
  111. Seishima M, Mizutani Y, Shibuya Y, et al. Efficacy of granulocyte and monocyte adsorption apheresis for three cases of refractory pyoderma gangrenosum. Ther Apher Dial 2007; 11:177.
  112. Fujimoto E, Fujimoto N, Kuroda K, Tajima S. Leukocytapheresis treatment for pyoderma gangrenosum. Br J Dermatol 2004; 151:1090.
  113. Kanekura T, Maruyama I, Kanzaki T. Granulocyte and monocyte adsorption apheresis for pyoderma gangrenosum. J Am Acad Dermatol 2002; 47:320.
  114. Okuma K, Mitsuishi K, Hasegawa T, et al. A case report of steroid and immunosuppressant-resistant pyoderma gangrenosum successfully treated by granulocytapheresis. Ther Apher Dial 2007; 11:387.
  115. Watanabe Y, Yamada H. Leukocyte adsorption apheresis for the treatment of pyoderma gangrenosum. J Dermatol 2008; 35:792.
  116. Saracino A, Kelly R, Liew D, Chong A. Pyoderma gangrenosum requiring inpatient management: a report of 26 cases with follow up. Australas J Dermatol 2011; 52:218.
  117. Powell FC, Schroeter AL, Su WP, Perry HO. Pyoderma gangrenosum: a review of 86 patients. Q J Med 1985; 55:173.
  118. Abdelrazeq AS, Lund JN, Leveson SH. Pouchitis-associated pyoderma gangrenosum following restorative proctocolectomy for ulcerative colitis. Eur J Gastroenterol Hepatol 2004; 16:1057.
  119. Pishori T, Qureshi AH. Post-colectomy peristomal pyoderma gangrenosum. J Coll Physicians Surg Pak 2005; 15:121.
  120. Yanaru-Fujisawa R, Matsumoto T, Nakamura S, et al. Granulocyte apheresis for pouchitis with arthritis and pyoderma gangrenosum after restorative proctocolectomy for ulcerative colitis: a case report. Inflamm Bowel Dis 2005; 11:780.
  121. Holmlund DE, Wählby L. Pyoderma gangrenosum after colectomy for inflammatory bowel disease. Case report. Acta Chir Scand 1987; 153:73.
  122. Cox NH, Peebles-Brown DA, MacKie RM. Pyoderma gangrenosum occurring 10 years after proctocolectomy for ulcerative colitis. Br J Hosp Med 1986; 36:363.
  123. Ruocco E, Sangiuliano S, Gravina AG, et al. Pyoderma gangrenosum: an updated review. J Eur Acad Dermatol Venereol 2009; 23:1008.