Development of pyoderma gangrenosum during therapy with infliximab

Jaimes-López, Natalia; Molina, Verónica; Arroyave, Juan Esteban; Vásquez, Luz Adriana; Ruíz, Ana Cristina; Castaño, Rodrigo; Ruiz, Mario H

doi:10.3315/jdcr.2009.1027

Cited by 28 publications

(25 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For one, as mentioned above, patients often have a coexisting immunemediated disease such as IBD or inflammatory arthritis (RA, ankylosing spondylitis, or other seronegative arthritis) (23)(24)(25)(26)(27)(28)(29)(30). Second, patients treated with immune modifying medications for other conditions rarely develop PG; for example, there have been separate case reports of patients developing PG in the setting of infliximab or granulocyte-macrophage colony-stimulating factor (GMCSF) therapy (31,32). Third, genetic diseases involving the immune system, such as leukocyte-adherence glycoprotein (LAD) deficiency, and PAPA syndrome, are associated with PG or PG-like lesions (33,34).…”

Section: Pathophysiologymentioning

confidence: 95%

Effective Strategies for the Management of Pyoderma Gangrenosum: A Comprehensive Review

Patel¹,

Fitzmaurice²,

Duong³

et al. 2015

Acta Derm Venerol

105

115

View full text Add to dashboard Cite

Pyoderma gangrenosum (PG) is an inflammatory disease characterized by painful skin ulcerations with undermined and erythematous borders. The etiology of PG is not well understood, but it is generally considered to be an aberrant immune response characterized by a dermal neutrophilc infiltrate. Given the existence of only a few PG clinical trials, treatment options are largely based upon anecdotal data and small case studies. In addition to classic immunosuppressive medications, PG has been reported to respond well to the anti-TNF agents, infliximab, etanercept, adalimumab. Newer biologics such as ustekinumab (anti-IL-23), ixekizumab (anti-IL-17) and brodalumab (anti-IL-17R) are promising given the effect of IL-17 on neutrophil migration. However, the effectiveness of these newer agents remains to be rigorously evaluated. Multi-drug regimens have not been well described in the literature but are an excellent alternative for patients with refractory disease. Herein, we provide a comprehensive review of the pathophysiology of PG and of the different treatments available for managing PG patients, including the theoretical benefit of initiating multidrug regimens. We also provide one possible treatment algorithm for patients with refractory disease and give examples of refractory PG cases successfully treated with multidrug regimens.

show abstract

Section: Pathophysiologymentioning

confidence: 95%

Effective Strategies for the Management of Pyoderma Gangrenosum: A Comprehensive Review

Patel¹,

Fitzmaurice²,

Duong³

et al. 2015

Acta Derm Venerol

105

115

View full text Add to dashboard Cite

show abstract

“…13 In our case, application of systemic corticosteroids was sufficient to obtain rapid, significant improvement. Efficacy of immunosuppressive therapy may be considered as a final proof of the diagnosis of pyoderma gangrenosum.…”

Section: Diagnosismentioning

confidence: 84%

A case of atypical pyoderma gangrenosum

Vasili

Shkodrani²,

Labinoti³

et al. 2010

J Dermatol Case Rep

View full text Add to dashboard Cite

Background: Pyoderma gangrenosum is a rare inflammatory disease of unknown etiology and unspecific histopathology. There are no clear-cut criteria for the diagnosis of this disease. The diagnosis is usually made based on clinical appereance, course of disease and possible, commonly coexisting disorders. In atypical cases the diagnosis is based on exclusion of other causes of similar appearing cutaneous ulcerations.Main observations: The 67-year-old male patient, presented with a 15-year history of painful ulcers and vegetative lesions covered with sero-hemorrhagic and purulent secretions, localized on the dorsal surface of both hands leading to self-amputation of distal phalanges. We report a step-by-step The patient refers to have these complaints for more than 15 years. An extensive diagnostic procedure led to the diagnosis of pyoderma gangrenosum as a diagnosis of exclusion.Conclusion: This report shows an atypical variant of an ulcerative disease. Pyoderma gangrenosum, a diagnosis of exclusion, was sustained based on an extensive diagnostic procedure. In this article we describe the step-by-step approach which let to this diagnosis.

show abstract

“…En la fase de mantención destacan los antagonistas del factor de necrosis tumoral, que a pesar de los costos están indicados en casos refractarios al tratamiento habitual, además de ser efectivos contra la enfermedad de base 9 . Sin embargo, se han descrito casos de PG periileostómico que se presentan durante el tratamiento con infliximab 10 .…”

Section: Discussionunclassified

Pioderma Gangrenoso Gigante De Curso Fulminante Asociado a Enfermedad Inflamatoria Intestinal

2014

Rev Chil Cir

View full text Add to dashboard Cite

Giant pyoderma gangrenosum associated with an inflammatory bowel diseaseBackground: Pyoderma gangrenosum (PG) is an uncommon neutrophilic dermatosis that presents as an inflammatory and ulcerative disorder of the skin. Case report: We report a 23 years old male subjected to a total colectomy and ileostomy due to a toxic megacolon associated with an inflammatory bowel disease. Ten months later, he suffered an infected abdominal wall dehiscence after a surgical intervention for a bowel obstruction. The patient presented confluent ulcerated skin lesions surrounding the ileostomy and drainage sites, associated with severe malaise and without response to antimicrobial treatment. Presuming the presence of a giant and fulminant pyoderma gangrenosum associated with Crohn's disease, the patient was treated with adrenal steroids and immunosuppressive agents. One month later an enterocutaneous fistula appeared. Thereafter the patient experienced a slow but progressive recovery with a complete healing of the skin lesion and closure of enterocutaneous fistula after four years of immunosuppressive and anti-tumor necrosis factor treatment. The basis of the treatment of this patient was the use of immunosuppressive agents.

show abstract

Development of pyoderma gangrenosum during therapy with infliximab

Cited by 28 publications

References 25 publications

Effective Strategies for the Management of Pyoderma Gangrenosum: A Comprehensive Review

Effective Strategies for the Management of Pyoderma Gangrenosum: A Comprehensive Review

A case of atypical pyoderma gangrenosum

Pioderma Gangrenoso Gigante De Curso Fulminante Asociado a Enfermedad Inflamatoria Intestinal

Contact Info

Product

Resources

About