BACKGROUND: Pyoderma gangrenosum (PG) often necessitates long-term immunosuppressant therapy. Many patients may receive treatment for longer periods and higher doses than is clinically necessary because clinicians may have difficulty differentiating between active disease and an inactive residual ulcer that is often slow to heal. OBJECTIVE: Recognition of the correct point to begin tapering therapy can help reduce the risk of adverse effects associated with treatment. RESULTS: This article describes Gulliver's sign, a recognizable transition in PG patients which indicates that inflammation is under control. CONCLUSION: This sign can be used to guide the tapering of corticosteroids and other immunosuppressant therapies in the treatment of PG.
BACKGROUND:Pyoderma gangrenosum (PG) often necessitates long-term immunosuppressant therapy. Many patients may receive treatment for longer periods and higher doses than is clinically necessary because clinicians may have difficulty differentiating between active disease and an inactive residual ulcer that is often slow to heal. OBJECTIVE: Recognition of the correct point to begin tapering therapy can help reduce the risk of adverse effects associated with treatment. RESULTS: This article describes Gulliver's sign, a recognizable transition in PG patients which indicates that inflammation is under control. CONCLUSION: This sign can be used to guide the tapering of corticosteroids and other immunosuppressant therapies in the treatment of PG.