Corticosteroid-resistant pyoderma gangrenosum associated with Crohn's disease: rapid cure with infliximab.
A 41-year-old woman with Crohn's disease had a severe and rapidly extensive corticosteroid-resistant pyoderma gangrenosum (PG) of the leg. She had been treated 2 years previously with antibiotics and surgery for a similar lesion of the back of the hand which had been diagnosed as a fulminating infection. Infliximab 5 mg/kg was given at weeks 0, 5 and 9. A dramatic response was observed within 72 h with a favourable effect persisting for 4 weeks after each infliximab infusion. A complete healing was achieved at week 11. This case illustrates that (1). PG of the hand is frequently misdiagnosed as an infection and treated with inappropriate therapies; (2). infliximab may be an interesting alternative in corticosteroid-resistant PG associated with Crohn's disease.
Grange
F
F
Department of Dermatology, Hôpital Pasteur, Colmar, France. florent.grange@ch-colmar.rss.fr
Djilali-Bouzina
F
F
Weiss
A M
AM
Polette
A
A
Guillaume
J C
JC
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003424:Crohn Disease / Q000150:complications*; D003879:Dermatologic Agents / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D000069285:Infliximab; D007866:Leg; D017511:Pyoderma Gangrenosum / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*
D000911:Antibodies, Monoclonal; D003879:Dermatologic Agents; D000069285:Infliximab