Pyoderma gangrenosum--rebel without a cure?

International Journal of Dermatology
Sharon E JacobFrancisco A Kerdel

Abstract

Pyoderma gangrenosum (PG) is a rare neutrophilic, ulcerating dermatosis that is frequently difficult to diagnose and often a diagnosis of exclusion. It is hypothesized that PG may be caused by an abnormal T-cell and neutrophil response, which correlates with its common link to other disorders, such as inflammatory bowel disease, rheumatoid arthritis, and malignancies. Several treatments have been used successfully for PG, but none has proven to be universally effective. We present three cases of PG treated with adalimumab after failed courses of steroids (orally and parenterally), thalidomide, cyclosporine, and mycophenolate mofetil. Patients 2 and 3, who had previously responded to infliximab, albeit with recurrence, were successfully treated with adalimumab at a dose of 40 mg once a week. Patient 1 initially responded to adalimumab, but after 7.5 months failed to show wound bed improvement at a dose of 80 mg/week subcutaneously. This patient had not previously been treated with infliximab. We believe adalimumab to be a valuable alternative for the treatment of PG, with comparable efficacy to infliximab.

References

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Citations

Nov 7, 2012·Indian Dermatology Online Journal·Ramesh M Bhat
May 15, 2010·Revista clínica española·I Pérez-De PedroM T Camps-García
Mar 17, 2010·Journal of the American Academy of Dermatology·Jeremiah MillerSteven R Feldman
Nov 15, 2008·International Journal of Dermatology·Lizelotte J M T ParrenPamela Poblete-Gutiérrez
Aug 7, 2013·Alimentary Pharmacology & Therapeutics·A Agarwal, J M Andrews
Jul 28, 2018·The Journal of Dermatological Treatment·Fatima McKenzieAlex G Ortega-Loayza
Jan 4, 2019·International Wound Journal·Hakim Ben AbdallahRikke Bech
Nov 3, 2010·Current Opinion in Rheumatology·Uwe Wollina, Gunter Haroske
May 1, 2020·Paediatric Drugs·Quoc-Bao D NguyenAdelaide A Hebert
Feb 24, 2012·American Journal of Clinical Dermatology·Iris AhronowitzKanade Shinkai
Sep 14, 2012·Journal of Cutaneous Medicine and Surgery·Roberto CecchiLuigi Brunetti

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