Dehydrated XXXX Amnion/Chorion Membrane as Adjunctive Therapy in the Multidisciplinary Treatment of Pyoderma Gangrenosum: A Case Report.

@entity1 @entity6794 @entity6 @entity39 @entity158 @entity272 @entity4760
UNASSIGNED: @entity6794 ( @entity6794 ) is an uncommon chronic and progressive @entity272 that can lead to severe tissue @entity39 , pathergy, @entity158 , and disfigurement if not properly and promptly diagnosed and treated. Systemic treatment traditionally consists of long-term immunosuppression. Topical care of the @entity158 wound often represents a clinical challenge. A 77-year-old @entity1 with multiple comorbidities including @entity6 was diagnosed through exclusion with refractory, @entity158 @entity6794 . She was managed for 3 months by a multidisciplinary team comprised of an internist, 2 dermatologists, and a podiatric wound care specialist using immunosuppressive therapy, several local wound care modalities, and supportive bandages. During that time, severe @entity158 continued unabated and the affected area changed from 3 separate wounds measuring 1.4 cm x 1.0 cm x .01 cm, 1.2 cm x 0.5 cm x 0.1 cm, and 0.6 cm x 0.5 cm x 0.1 cm to 1 wound measuring 8.0 cm x 10.3 cm x 0.1 cm. At that time, dehydrated @entity1 amnion/chorion membrane (dHACM) allograft, previously reported to facilitate healing venous leg and @entity4760 , was incorporated into the treatment plan. The @entity1 reported @entity158 decreased from 10 out of 10 to 5 out of 10 within hours following application. At the 4 day follow-up visit, she reported no @entity158 ; after 1 week, the wound decreased 6.4 cm x 9.4 cm x 0.1 cm in size and after 2 months (3 applications) the wound had reduced in area from 103 cm2 to 57.96 cm2 (reduced by more than half [56%]). In this @entity1 , following the application of dHACM as an adjunct to immunosuppressive therapy, @entity158 receded and wound healing commenced. Additional controlled studies are needed to ascertain the generalizability of this observation.
