Xin Weiwei, Gu Liyang, Du Fang, Li Ting, Ye Shuang
Department of Orthopedics, Renji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China.
Department of Rheumatology, Renji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China.
Front Immunol. 2025 Apr 7;16:1581996. doi: 10.3389/fimmu.2025.1581996. eCollection 2025.
Pyoderma gangrenosum (PG) is a classic neutrophilic dermatosis often associated with inflammatory conditions, frequently leading to misdiagnosis and delayed treatment. Drug-induced and postoperative are two potential triggers of PG. A 70-year-old woman, who had been treated with Ixekizumab for undifferentiated oligoarthritis, presented with cribriform violaceous ulcers on her right posterior ankle after 8 months of debridement. A skin biopsy revealed a predominant neutrophilic infiltrate with no signs of infection after extensive microbiology investigation. The patient was diagnosed with pyoderma gangrenosum (PG) and achieved remission after receiving three doses of 900 mg intravenous Spesolimab every 4 weeks, along with discontinuation of Ixekizumab. The case highlights the successful use of Spesolimab (anti-IL36R) in treating PG and explores the potential "paradoxical phenomenon" linked to anti-IL-17 therapy, providing novel insights into immune dysregulation and therapeutic strategies.
坏疽性脓皮病（PG）是一种典型的嗜中性皮病，常与炎症性疾病相关，常导致误诊和治疗延迟。药物性和术后是PG的两个潜在触发因素。一名70岁女性，因未分化寡关节炎接受司库奇尤单抗治疗，在清创8个月后，右后踝出现筛状紫罗兰色溃疡。皮肤活检显示，经过广泛的微生物学检查后，主要为嗜中性浸润，无感染迹象。该患者被诊断为坏疽性脓皮病（PG），每4周接受3剂900mg静脉注射司泊利单抗治疗，并停用司库奇尤单抗后病情缓解。该病例突出了司泊利单抗（抗IL36R）在治疗PG方面的成功应用，并探讨了与抗IL-17治疗相关的潜在“矛盾现象”，为免疫失调和治疗策略提供了新的见解。
