Efficacy of Hyperbaric Oxygen Therapy in the Treatment of Pyoderma Gangrenous

Abstract

Pyoderma gangrenosum (PG) is a rare and severe neutrophilic dermatosis characterized by the formation of painful and frequently debilitating skin ulcers. Although the definite causes of PG remains uncertain, current evidence has suggested that the condition development might be associated with dysfunctions of the immune system along with multiple systematic conditions. Over the past years, hyperbaric oxygen therapy (HBOT) has been used as an adjuvant treatment in various chronic conditions, including PG. The retrospective, observational, and descriptive study presented here aims to evaluate the effectiveness of HBOT in treating patients with PG, treated at the Centro Mineiro de Medicina Hiperbárica. Additionally, the investigation seeks to identify treatment response patterns, considering factors such as patient age, the number of HBOT sessions required, and the total duration of treatment. The study sample comprised ten patients diagnosed with PG who underwent HBOT from January 2000 to December 2022. Most patients were female, with ages ranging from 43 and 72 years.  A significant reduction in the area of skin lesions was observed in several patients, indicating a positive response to the treatment. Specifically, 70% of the patients experienced a decrease in the size of their lesions, in which some cases exhibited significant enhancement in areas originally affected by necrosis. Wounds were located in multiple topographies (i.e., perimalleolar, surral, and patellar regions) besides the abdominal and gluteal areas.  The duration of treatment varied significantly, spanning from months to years, according to the primary wound features. Despite the positive findings observed in our study, the definitive effectiveness of HBOT in managing PG necessitates further experimental evaluation, based on larger patient cohorts and more robust methodological designs. This highlights the inherent limitations attributed to our study and emphasizes the need for future research in the field of wound healing.