Infliximab for the Treatment of Disseminated Pyoderma Gangrenosum Associated with Ulcerative Colitis

Abstract

We report the case of a 19-year-old woman who developed an acute disseminated pyoderma gangrenosum (PG) during a severe flare of ulcerative colitis (UC). She was successfully treated with a 3-dose regimen of the anti-tumor-necrosis-factor-α antibody infliximab. The literature on the effectiveness of this biological agent was reviewed, including 8 other cases of UC-associated PG and 77 cases of Crohn’s-disease-associated PG. This case report and the review of the literature demonstrate that infliximab can be successfully used to treat patients with PG associated with inflammatory bowel diseases.

Paradoxical Reactions to Targeted Biological Treatments: A Way to Treat and Trigger?

“…Many reports regarding the successful use of infliximab for PG (10) are in contrast with two reported cases (including ours) of PG onset during anti-TNF-a therapy (II). Although PG has been widely reported with IBD (10), its onset during infliximab therapy is again a paradox.…”

Infliximab for the Treatment of Refractory Adamantiades-Behçet Disease with Articular, Intestinal, Cerebral and Ocular Involvement

“…Table 1 summarizes the published cases of acute and/or severe ABD treated with IFX and shows how satisfactory the response to the TNF-␣ inhibitor is, with 76/99 patients experiencing complete remission, 15 patients with partial remission and only 8 patients showing no response. Further, IFX has also been reported as a successful treatment option in refractory pyoderma gangrenosum [39,40] , thus underlining its effectiveness in neutrophilic processes. The clinical course of ABD is mostly unpredictable, with possible relapses even despite adequate therapy.…”

Extraintestinal Manifestations of Crohn’s Disease

“…The effectiveness of infliximab for CD-associated PG is reported in many articles and abstracts [67,68,69,70,71,72,73,74,75,76]. Tan et al [74 ]reported the first promising results in 2 PG-associated CD patients.…”