Department of Dermatology, Oregon Health and Science University, Portland, OR, USA.
Department of Dermatology, Central State Medical Academy, Moscow, Russia.
Clin Exp Dermatol. 2021 Aug;46(6):1082-1085. doi: 10.1111/ced.14683. Epub 2021 May 29.
Pyoderma gangrenosum (PG) is a rare, debilitating, inflammatory skin disease associated with a variety of systemic diseases. Because of its rarity, PG is treated with miscellaneous immunosuppressive agents as there is no US Food and Drug Administration-approved standardized treatment approach. We present four patients with PG treated with tofacitinib in the context of the six existing cases in the literature. Tofacitinib appeared to be beneficial in the small sample of patients (n = 10) who failed an average of four other systemic therapies. The majority of patients had classic PG located on the legs (80%, 8/10), while 20% of cases (2/10) were peristomal. The most common comorbidity was inflammatory bowel disease (78%, 7/9). There were no negative treatment results and 40% (4/10) of patients had complete healing of their ulcers, while the other 60% (6/10) had marked clinical improvement. From our observation, tofacitinib appears to be a promising steroid-sparing adjuvant treatment in patients with refractory PG who have failed on other systemic therapies.
坏疽性脓皮病（PG）是一种罕见的、使人虚弱的炎症性皮肤病，与多种系统性疾病有关。由于其罕见性，PG 采用各种免疫抑制剂进行治疗，因为没有美国食品和药物管理局批准的标准化治疗方法。我们报告了 4 例 PG 患者，他们在文献中的 6 例现有病例的背景下接受了托法替尼治疗。托法替尼似乎对平均接受了 4 种其他全身性治疗失败的小样本患者（n=10）有益。大多数患者的典型 PG 位于腿部（80%，8/10），而 20%的病例（2/10）位于肠造口周围。最常见的合并症是炎症性肠病（78%，7/9）。没有出现治疗不良反应，40%（4/10）的患者溃疡完全愈合，而其他 60%（6/10）的患者临床症状明显改善。根据我们的观察，托法替尼似乎是一种有前途的类固醇辅助治疗药物，适用于对其他全身性治疗无效的难治性 PG 患者。
