title: Certolizumab pegol - A new therapeutic option for refractory disseminated pyoderma gangrenosum associated with Crohn's disease.
abstract: Systemic steroids, in association or not with cyclosporin, are indicated for the treatment of large or widespread Pyoderma gangrenosum (PG). We report the case of a 27-year-old woman with a 15-year history of severe Crohn's disease, who developed a severe and disseminated PG, refractory to multiple lines of treatment. Infliximab and adalimumab were contraindicated, either because of allergy or of ineffectiveness on Crohn's disease. The addition of certolizumab pegol to the baseline treatment, associating systemic steroids and tacrolimus, finally allowed the complete healing of PG. Oral prednisone was stopped and tacrolimus was decreased, without any cutaneous or digestive relapse. Certolizumab pegol could be an alternative therapy in the treatment of PG in case of intolerance or ineffectiveness of the other anti-tumor necrosis factor (anti-TNF) therapies.
authors.affiliation: a Department of Dermatology , Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (APHP) , Paris , France .
authors.forename: Charlotte
authors.initials: C
authors.lastname: Hurabielle
authors.affiliation: a Department of Dermatology , Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (APHP) , Paris , France .|b Université Paris Diderot , Sorbonne Paris Cité , Paris , France , and.
authors.forename: Pierre
authors.initials: P
authors.lastname: Schneider
authors.affiliation: b Université Paris Diderot , Sorbonne Paris Cité , Paris , France , and.|c Department of Gastroenterology , Hôpital Saint-Louis , APHP , Paris , France.
authors.forename: Clotilde
authors.initials: C
authors.lastname: Baudry
authors.affiliation: a Department of Dermatology , Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (APHP) , Paris , France .|b Université Paris Diderot , Sorbonne Paris Cité , Paris , France , and.
authors.forename: Martine
authors.initials: M
authors.lastname: Bagot
authors.affiliation: b Université Paris Diderot , Sorbonne Paris Cité , Paris , France , and.|c Department of Gastroenterology , Hôpital Saint-Louis , APHP , Paris , France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Allez
authors.affiliation: a Department of Dermatology , Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (APHP) , Paris , France .|b Université Paris Diderot , Sorbonne Paris Cité , Paris , France , and.
authors.forename: Manuelle
authors.initials: M
authors.lastname: Viguier
mesh_terms: D000328:Adult; D000068582:Certolizumab Pegol / Q000627:therapeutic use*; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D011241:Prednisone / Q000627:therapeutic use; D017511:Pyoderma Gangrenosum / Q000188:drug therapy* / Q000209:etiology; D012008:Recurrence; D012074:Remission Induction; D016559:Tacrolimus / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D014409:Tumor Necrosis Factor-alpha; D000068582:Certolizumab Pegol; D011241:Prednisone; D016559:Tacrolimus
keywords: Anti-tumor necrosis factor; inflammatory bowel disease; neutrophilic dermatosis; ulcer