title: Infliximab for peristomal pyoderma gangrenosum.
abstract: Peristomal pyoderma gangrenosum (PPG) is a variant of pyoderma gangrenosum (PG) that is more refractory to treatment. It is a cause of severe morbidity and poses a therapeutic challenge for the clinician. Infliximab (Remicade(R); Centocor, Malvern, PA, USA) is a chimeric monoclonal antibody directed against tumour necrosis factor-alpha that has been proven to be effective in the treatment of inflammatory bowel disease (IBD) and rheumatoid arthritis. Currently, very few reports exist documenting its use in the treatment of PG and none in the treatment of PPG. We describe our experience of treating three patients with IBD-associated PPG with infliximab. All patients tolerated the drug without significant side-effects. Two patients with PPG recovered completely following the administration of infliximab, and one patient had a partial response to the drug. We conclude that infliximab appears to be a safe and effective therapeutic alternative in patients with PPG.
authors.affiliation: Department of Dermatology, Johns Hopkins University School of Medicine, 720 Rutland Ave, Ross Building, Suite 771, Baltimore, MD 21205, USA.
authors.forename: D
authors.initials: D
authors.lastname: Mimouni
authors.forename: G J
authors.initials: GJ
authors.lastname: Anhalt
authors.forename: D J
authors.initials: DJ
authors.lastname: Kouba
authors.forename: H C
authors.initials: HC
authors.lastname: Nousari
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003424:Crohn Disease / Q000150:complications; D003879:Dermatologic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000069285:Infliximab; D008875:Middle Aged; D017511:Pyoderma Gangrenosum / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology
chemical_list: D000911:Antibodies, Monoclonal; D003879:Dermatologic Agents; D000069285:Infliximab