title: Dramatic resolution of disseminated pyoderma gangrenosum associated with monoclonal gammopathy after therapy with bortezomib and dexamethasone.
abstract: Pyoderma gangrenosum (PG) is an uncommon inflammatory and ulcerative skin disorder, which is commonly associated with systemic conditions such as inflammatory bowel disease, arthritis and haematological malignancies. It is widely stated that control of the underlying diseases may lead to resolution of PG. However, standard of care dictates that patients suffering with monoclonal gammopathy of undetermined significance or smouldering multiple myeloma (MM) should not receive therapy unless they progress to symptomatic MM. Here, we report a woman in her 40s with a disseminated corticodependent PG, resistant to any treatment attempted, including anti-tumoral necrosis factor (TNF) therapy in which bortezomib-dexamethasone regimen results in dramatic healing of all lesions in only a month. This case supports the belief that treatment of the underlying monoclonal gammopathy could be necessary when PG presents as an aggressive, non-responding skin disease.
authors.affiliation: Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Virginia
authors.identifier: http://orcid.org/0000-0003-4009-0525
authors.initials: V
authors.lastname: Velasco-Tamariz
authors.affiliation: Department of Hematology, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Carreño-Tarragona
authors.affiliation: Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Fátima
authors.initials: F
authors.lastname: Tous-Romero
authors.affiliation: Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Gil-de la Cruz
authors.affiliation: Department of Hematology, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Estela
authors.initials: E
authors.lastname: Martín-Clavero
authors.affiliation: Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Rivera-Díaz
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000069286:Bortezomib / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D010265:Paraproteinemias / Q000188:drug therapy*; D017511:Pyoderma Gangrenosum / Q000188:drug therapy*; D012883:Skin Ulcer / Q000188:drug therapy*; D016463:Sweet Syndrome / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D000970:Antineoplastic Agents; D000069286:Bortezomib; D003907:Dexamethasone
keywords: Monoclonal gammopathies; Multiple myeloma; Neutrophilic dermatosis; Pyoderma gangrenosum