Two percent topical phenytoin sodium solution in treating pyoderma gangrenosum: a cohort study

Abstract

Oral phenytoin is an extensively used medicine for the treatment of convulsive disorders. Topical phenytoin has also been used for various types of ulcers. To determine the effectiveness of 2% topical phenytoin sodium solution in treating recalcitrant pyoderma gangrenosum. Six patients with treatment-resistant pyoderma gangrenosum who attended to Dermatology Unit/Ward were taken to the study and applied topical 2% phenytoin sodium solution to the wounds alone with other systemic therapy. Response to the treatment was assessed weekly. Three patients had idiopathic PG and other three had secondary diseases. At the end of the 4th week four patients showed complete resolution of the ulcers whereas other two patients showed the partial resolution. No adverse effects were noted. Phenytoin sodium 2% solution is beneficial for pyoderma gangrenosum (PG) with various etiologies. It enhanced the healing of the ulcer especially when the patient has treatment resistant disease.

Figure 1

Patient 1 – before treatment.

Figure 2

Patient 1 – after 4 weeks.

Figure 3

Patient 2 – after 1 week.

Figure 4

Patient 2 – after 4‐week treatment.

Figure 5

Patient 6 – before treatment.

Figure 6

Patient 6 after 4‐week treatment. There is evidence of surface reduction and healthy granulation tissue which was not achieved while using topical betamethasone.