Hyperbaric oxygen treatment of pyoderma gangrenosum.

Effective treatment of the phagedenic ulcers of pyoderma gangrenosum has been difficult, and numerous therapeutic measures have been reported. Four recently reported cases have healed promptly with hyperbaric oxygen (HBO) therapy.1-3Our patient had extensive pyoderma gangrenosum that failed to heal despite treatment with sulfones and corticosteroids. Report of a Case A 23-year-old woman came to the University of Texas Medical Branch with a four-year history of persistent, pustular ulcerations that had been previously diagnosed as pyoderma gangrenosum. She had received the standard treatments for pyoderma gangrenosum, which included 60 mg/day of prednisone on two different occasions and sulfone therapy for the past three months, without resolution of the ulcerations. Examination disclosed a 35 × 15-cm purulent ulceration on the lower portion of the right leg and a 9 × 15-cm ulceration on the lower portion of the left leg (Fig 1). New erythematous papulopustules continued to develop around