When Is Recalcitrant Pyoderma Gangrenosum Truly Recalcitrant?

Background: The literature supports many different therapies used in recalcitrant pyoderma gangrenosum, which suggests that the pathophysiology is not yet understood. Our hypothesis is that certain patient demographic factors, including age or size of ulcer at presentation, may predict a poor clinical outcome. Objective: The goal of our study was to stimulate an analysis of pyoderma gangrenosum treatment failures to identify predisposing conditions that would increase the likelihood of failure. Conclusion: Patients older than 50 years of age or with an ulcer greater than 25 cm in diameter may have a poor outcome, but a systematic review of pyoderma gangrenosum treatment failures should be undertaken to support this hypothesis.