Fousekis Fotios S, Mpakogiannis Konstantinos, Karampinis Emmanouil, Mastorogianni Ioanna Nefeli, Christodoulou Dimitrios K, Papoutsaki Marina, Zampeli Evanthia, Katsanos Konstantinos H
Department of Gastroenterology and Hepatology, University Hospital of Ioannina, University of Ioannina, 45110 Ioannina, Greece.
Second Dermatology Department, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Clin Pract. 2025 Mar 11;15(3):57. doi: 10.3390/clinpract15030057.
Pyoderma gangrenosum (PG) is a rare inflammatory cutaneous disorder that frequently occurs in association with systemic diseases such as inflammatory bowel disease (IBD). This case report describes a 23-year-old female with Crohn's disease (CD) who developed PG and was successfully treated with adalimumab. The objective of this study is to present the clinical course, treatment approach, and outcomes while reviewing the existing literature on the efficacy of adalimumab in PG management. A case report is presented, detailing clinical presentation, diagnostic evaluation, and treatment strategy. Additionally, a systematic review was conducted using PubMed to assess studies on adalimumab in PG, focusing on treatment response, remission rates, and adverse effects. The patient presented with ulcerative lesions on her lower extremities and sacroiliitis. After corticosteroid therapy, adalimumab was initiated, leading to significant ulcer healing, reduced back pain, and CD remission. The systematic review identified seven studies on adalimumab in PG. Findings suggest that adalimumab is effective in steroid-refractory cases, with remission achieved in a significant proportion of patients. The most common adverse effects were infections, but overall, adalimumab showed a favorable safety profile. This case highlights the importance of early diagnosis and multidisciplinary management of PG in CD patients. Adalimumab appears to be a promising therapeutic option, particularly for steroid-resistant PG, though further research is needed to establish standardized treatment protocols.
坏疽性脓皮病（PG）是一种罕见的炎症性皮肤病，常与炎症性肠病（IBD）等全身性疾病相关。本病例报告描述了一名患有克罗恩病（CD）的23岁女性，她患上了PG，并通过阿达木单抗成功治愈。本研究的目的是介绍临床病程、治疗方法和结果，同时回顾关于阿达木单抗在PG治疗中疗效的现有文献。现报告一例病例，详细说明临床表现、诊断评估和治疗策略。此外，使用PubMed进行了一项系统综述，以评估关于阿达木单抗治疗PG的研究，重点关注治疗反应、缓解率和不良反应。该患者出现下肢溃疡性病变和骶髂关节炎。在皮质类固醇治疗后，开始使用阿达木单抗，导致溃疡显著愈合、背痛减轻和CD缓解。系统综述确定了七项关于阿达木单抗治疗PG的研究。研究结果表明，阿达木单抗在激素难治性病例中有效，相当比例的患者实现了缓解。最常见的不良反应是感染，但总体而言，阿达木单抗显示出良好的安全性。本病例强调了CD患者中PG早期诊断和多学科管理的重要性。阿达木单抗似乎是一种有前景的治疗选择，特别是对于激素抵抗性PG，不过需要进一步研究以建立标准化治疗方案。
