Topical Phenytoin — A New Therapy for Pyoderma Gangrenosum?

Topical phenytoin suspension has been used to treat wounds from various causes. The mechanism by which this agent works is unknown, but some reports implicate antibacterial effects, increases in fibroblast proliferation, and a decrease in collagenase activity. Whether it has any anti-inflammatory effect is not known. Pyoderma gangrenosum (PG) is often challenging to treat, and most patients eventually require oral corticosteroids along with immunosuppressive agents. Topical therapies for PG include superpotent corticosteroids, nicotine, cromolyn sodium, and tacrolimus ointment. Each agent has been reported to be of benefit in individual cases or in small case series. Investigators have now evaluated the addition of topical phenytoin 2% susp…