has been either ineffective or unable to be tolerated due to severity of side effects or contraindications. The safety profile of Ig means that it is useful when additional efficacy is required, without increasing levels of immunosuppression. Nevertheless, given the expense of Ig careful consideration should be given when considering its usage. Diagnosis is Yes By which Dermatologist Diagnosis is now required by a required specialty dermatologist or a clinical Clinical immunologist immunologist as these specialties manage patients with this rare Diagnosis No By which condition. must be specialty verified Exclusion Criteria Use of intravenous Qualifying criteria have been Qualifying Severe PG when immunosuppressant and biologic therapy is Criteria immunoglobulin (IVIg) is limited either ineffective or inappropriate due to unacceptable side developed in consultation with the to patients with significant effects. Australian College of pyoderma gangrenosum, Dermatologists. An assessment of diagnosed by a Dermatologist, Severe PG with large or persistent ulceration causing the patient’s quality of life is unresponsive to corticosteroids significant impact on quality of life required as well as the size and and other immunosuppressive AND persistence of ulcers. agents. Unresponsive to a trial of oral corticosteroid therapy for at least 6 weeks Criteria confirm that the patient has been unresponsive to at least six OR weeks’ treatment with corticosteroids and a further eight week trial of cyclosporin with prednisolone, Corticosteroid therapy is contraindicated or has resulted in mycophenalate mofetil with unacceptable side effects or significant toxicity prednisolone, methotrexate with
has been either ineffective or unable to be tolerated due to severity of side effects or contraindications. The safety profile of Ig means that it is useful when additional efficacy is required, without increasing levels of immunosuppression. Nevertheless, given the expense of Ig careful consideration should be given when considering its usage. Diagnosis is required Yes By which specialty Dermatologist Clinical immunologist Diagnosis is now required by a dermatologist or a clinical immunologist as these specialties manage patients with this rare condition. Diagnosis must be verified No By which specialty Exclusion Criteria Qualifying Criteria Use of intravenous immunoglobulin (IVIg) is limited to patients with significant pyoderma gangrenosum, diagnosed by a Dermatologist, unresponsive to corticosteroids and other immunosuppressive agents. Severe PG when immunosuppressant and biologic therapy is either ineffective or inappropriate due to unacceptable side effects. Severe PG with large or persistent ulceration causing significant impact on quality of life AND Unresponsive to a trial of oral corticosteroid therapy for at least 6 weeks OR Corticosteroid therapy is contraindicated or has resulted in unacceptable side effects or significant toxicity Qualifying criteria have been developed in consultation with the Australian College of Dermatologists. An assessment of the patient’s quality of life is required as well as the size and persistence of ulcers. Criteria confirm that the patient has been unresponsive to at least six weeks’ treatment with corticosteroids and a further eight week trial of cyclosporin with prednisolone, mycophenalate mofetil with prednisolone, methotrexate with