Leow Liang Joo, Zubrzycki Nicolas
Aesthetic Dermatology, Sydney, NSW, Australia.
Department of Dermatology, St Vincent's Private Hospital, Sydney, NSW, Australia.
Clin Cosmet Investig Dermatol. 2022 Aug 23;15:1729-1736. doi: 10.2147/CCID.S374534. eCollection 2022.
Elevated levels of inflammatory mediators-including the interleukin IL-23-are implicated in the pathogenesis of pyoderma gangrenosum (PG), an autoinflammatory neutrophilic dermatosis characterized by rapidly enlarging, suppurative ulcers and cribriform scarring. Here, we present the first case report of significant response of isolated ulcerative PG with tildrakizumab, a biologic agent directed against the p19 subunit of IL-23, in an elderly woman with extensive treatment-refractory PG on her left leg. Tildrakizumab (100 mg subcutaneously at weeks 0 and 4, then every 8 weeks, and eventually increased in frequency to every 6 weeks), combined with acetic acid soaks each morning and chemical debridement every evening with 3% hydrogen peroxide, resulted in progressive decrease in ulcer size and depth, re-epithelialization, and recovery of sensory perception. This report describes the dramatic clinical response of ulcerative PG on the leg with tildrakizumab.
炎症介质水平升高，包括白细胞介素IL - 23，与坏疽性脓皮病（PG）的发病机制有关。PG是一种自身炎症性嗜中性皮肤病，其特征为迅速扩大的化脓性溃疡和筛状瘢痕。在此，我们报告首例使用替拉珠单抗治疗孤立性溃疡性PG取得显著疗效的病例。该病例为一名老年女性，左腿患有广泛且治疗难治性PG。替拉珠单抗（第0周和第4周皮下注射100mg，然后每8周一次，最终频率增加至每6周一次），联合每天早晨用醋酸浸泡以及每晚用3%过氧化氢进行化学清创，导致溃疡大小和深度逐渐减小、重新上皮化以及感觉恢复。本报告描述了腿部溃疡性PG使用替拉珠单抗后的显著临床反应。
