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Hyperbaric Oxygen Treatment of Pyoderma Gangrenosum

Walter J. Wyrick, MD; Jon T. Mader, MD; M. Ellen Butler, MS; William H. Hulet, MD
[+] Author Affiliations

From the Marine Biomedical Institute (Dr Hulet and Ms Butler) and the Departments of Dermatology (Dr Wyrick) and Medicine (Dr Mader), University of Texas Medical Branch Galveston.


Arch Dermatol. 1978;114(8):1232-1233. doi:10.1001/archderm.1978.01640200084028
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Effective treatment of the phagedenic ulcers of pyoderma gangrenosum has been difficult, and numerous therapeutic measures have been reported. Four recently reported cases have healed promptly with hyperbaric oxygen (HBO) therapy.1-3 Our patient had extensive pyoderma gangrenosum that failed to heal despite treatment with sulfones and corticosteroids.

Report of a Case  A 23-year-old woman came to the University of Texas Medical Branch with a four-year history of persistent, pustular ulcerations that had been previously diagnosed as pyoderma gangrenosum. She had received the standard treatments for pyoderma gangrenosum, which included 60 mg/day of prednisone on two different occasions and sulfone therapy for the past three months, without resolution of the ulcerations.Examination disclosed a 35 × 15-cm purulent ulceration on the lower portion of the right leg and a 9 × 15-cm ulceration on the lower portion of the left leg (Fig 1). New erythematous papulopustules continued to develop around

REFERENCES

Barr PO, Enfors W, Eriksson G:  Hyperbaric oxygen therapy in dermatology . Br J Dermatol 86:631-635, 1972;.
Thomas CY, Crouch JA, Guastello J:  Hyperbaric oxygen therapy for pyoderma gangrenosum . Arch Dermatol 110:445-446, 1974;.
Fuhrman DL:  Hyperbaric oxygen therapy . Arch Dermatol 111:657, 1975;.
Hill GB:  Hyperbaric oxygen exposures for intraheptic abscesses produced in mice by nonspore forming aerobic bacteria . Antimicrob Agents Chemother 9:312-317, 1976;.
Hunt TK, Linsey M, Grislis G, et al:  The effect of differing ambient oxygen tensions on wound infection . Ann Surg 181:35-39, 1975;.
Mandell GL:  Bactericidal activity of aerobic and anaerobic polymorphonuclear neutrophils . Infect Immun 9:337-341, 1974;.
Hoeprich PD:  Chemoprophylaxis of infectious diseases , in Hoeprich PD (ed): Infectious Diseases . Hagerstown, Md, Harper & Row Publishers Inc, 1977;, pp 190-206.

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Barr PO, Enfors W, Eriksson G:  Hyperbaric oxygen therapy in dermatology . Br J Dermatol 86:631-635, 1972;.
Thomas CY, Crouch JA, Guastello J:  Hyperbaric oxygen therapy for pyoderma gangrenosum . Arch Dermatol 110:445-446, 1974;.
Fuhrman DL:  Hyperbaric oxygen therapy . Arch Dermatol 111:657, 1975;.
Hill GB:  Hyperbaric oxygen exposures for intraheptic abscesses produced in mice by nonspore forming aerobic bacteria . Antimicrob Agents Chemother 9:312-317, 1976;.
Hunt TK, Linsey M, Grislis G, et al:  The effect of differing ambient oxygen tensions on wound infection . Ann Surg 181:35-39, 1975;.
Mandell GL:  Bactericidal activity of aerobic and anaerobic polymorphonuclear neutrophils . Infect Immun 9:337-341, 1974;.
Hoeprich PD:  Chemoprophylaxis of infectious diseases , in Hoeprich PD (ed): Infectious Diseases . Hagerstown, Md, Harper & Row Publishers Inc, 1977;, pp 190-206.

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