Salvia Giorgia, Michelucci Alessandra, Granieri Giammarco, Manzo Margiotta Flavia, Bevilacqua Matteo, Fidanzi Cristian, Panduri Salvatore, Romanelli Marco, Dini Valentina
Department of Dermatology, 9310University of Pisa, Pisa, Italy.
Int J Low Extrem Wounds. 2023 Jan 3:15347346221148818. doi: 10.1177/15347346221148818.
Pyoderma gangrenosum (PG) is a neutrophilic inflammatory dermatosis, whose management still represents a clinical challenge due to frequent unresponsive cases. The aim of our study was to evaluate the efficacy of a novel, combined approach including local wound management, based on the principle of PG-TIME and a systemic therapy with an anti interleukin (IL)-17A monoclonal antibody (mAb). We presented a case of a 37-year-old female patient, affected by multi-refractory PG. The patient was treated with a combined approach of both local and systemic therapy. Wound clinical improvement was assessed by Wound Bed Score (WBS), wound size was evaluated through 3D camera laser scanner, and pain was evaluated with visual analog scale (VAS). After 52 weeks of therapy, the association of local wound management with ixekizumab 80 mg [160 mg at time (T) 0; 80 mg every 2 weeks until week 12; 80 mg every 4 weeks] allowed us to perform skin grafting and obtain complete wound healing. Our clinical case demonstrated the efficacy of a novel combination therapy for the treatment of recalcitrant PG based on IL-17 mAbs and local wound management built on the main features of PG-TIME.
坏疽性脓皮病（PG）是一种嗜中性粒细胞性炎性皮肤病，由于经常出现无反应病例，其治疗仍然是一项临床挑战。我们研究的目的是评估一种新的联合治疗方法的疗效，该方法包括基于PG-TIME原则的局部伤口处理和使用抗白细胞介素（IL）-17A单克隆抗体（mAb）的全身治疗。我们报告了一例37岁的女性患者，患有多重难治性PG。该患者接受了局部和全身联合治疗。通过伤口床评分（WBS）评估伤口临床改善情况，通过三维相机激光扫描仪评估伤口大小，并用视觉模拟量表（VAS）评估疼痛。经过52周的治疗，局部伤口处理与80毫克依奇珠单抗联合使用[第0次给药时（T）160毫克；第12周前每2周80毫克；第12周后每4周80毫克]使我们能够进行皮肤移植并实现伤口完全愈合。我们的临床病例证明了一种基于IL-17单克隆抗体和基于PG-TIME主要特征的局部伤口处理的新型联合疗法治疗顽固性PG的疗效。
