INTRAVENOUS CYCLOPHOSPHAMIDE PULSES IN THE TREATMENT OF PYODERMA-GANGRENOSUM ASSOCIATED WITH RHEUMATOID-ARTHRITIS - REPORT OF 2 CASES AND REVIEW OF THE LITERATURE

Pyoderma gangrenosum is a chronic ulceronecrotic inflammatory cutaneou s disorder that can be associated with diseases such as rheumatoid art hritis (RA). No definitive treatment exists for this condition; steroi ds have been the mainstay of therapy, and the addition of immunosuppre ssives has been advocated. We describe 2 patients with pyoderma gangre nosum occurring in the setting of RA who, in addition to steroids, rec eived pulse intravenous cyclophosphamide and had a remarkably good and lasting response. This is the first report of such a therapeutic appr oach. The pertinent literature is discussed. We conclude that pulse cy clophosphamide is another possible therapy for pyoderma gangrenosum.