Clinical efficacy of crushed prednisolone and hydrocolloid powder in the primary treatment of peristomal pyoderma gangrenosum and correlation to in vitro drug release data

Int Wound J. 2024 Mar;21(3):e14808. doi: 10.1111/iwj.14808.

Abstract

We evaluated the primary application of crushed prednisolone combined with hydrocolloid powder for clinically diagnosed peristomal pyoderma gangrenosum (PPG). We present our data on this cohort and follow-up of our previous patients. Of the 23 patients who were commenced on this regime, 18 healed (78%). Twenty-two patients commenced on this regime as the primary treatment for their PPG, and for one, it was a rescue remedy after failed conventional therapy. Four patients with significant medical comorbidities failed to heal and one had their stomal reversal surgery before being fully healed. The proposed treatment regime for PPG is demonstrated to be effective, inexpensive and able to be managed in the patient's usual home environment. In vitro drug release analysis was undertaken, and data are presented to provide further insights into the efficacy of this regime.

Keywords: Franz cells; hydrocolloid powder; peristomal pyoderma gangrenosum; prednisolone; stoma.

MeSH terms

  • Drug Liberation
  • Humans
  • Powders / therapeutic use
  • Prednisolone* / therapeutic use
  • Pyoderma Gangrenosum* / diagnosis
  • Pyoderma Gangrenosum* / drug therapy
  • Pyoderma Gangrenosum* / etiology
  • Treatment Outcome

Substances

  • Prednisolone
  • Powders