Horth Damy, Assouyat Nora, Auger Isabelle
Department of Dermatology, Université Laval, Québec, QC, Canada.
Department of Medicine, Université Laval, Québec, QC, Canada.
SAGE Open Med Case Rep. 2025 Jun 20;13:2050313X251352130. doi: 10.1177/2050313X251352130. eCollection 2025.
Pyoderma gangrenosum is a neutrophilic dermatosis characterized by rapidly progressing inflammatory skin lesions. It is often associated with underlying systemic conditions, such as inflammatory bowel disease and rheumatoid arthritis. Patients typically present with erythematous papules and pustules that rapidly evolve into painful ulcers, most commonly affecting the lower extremities. In this case report, we describe a 57-year-old female patient with multirefractory pyoderma gangrenosum localized to the lower left leg. The diagnosis was confirmed based on clinical and histopathological features, with a skin biopsy showing compatible findings. Initial treatments, including topical therapies (high-potency steroids, dapsone, and calcineurin inhibitors) and conventional systemic immunosuppressive therapies (corticosteroids and tumor necrosis factor inhibitors), failed to produce significant improvement. However, treatment with risankizumab, an interleukin-23 inhibitor, resulted in substantial ulcer healing over a few weeks and ultimately led to complete resolution.
坏疽性脓皮病是一种以迅速进展的炎症性皮肤病变为特征的嗜中性皮肤病。它常与潜在的全身性疾病相关，如炎症性肠病和类风湿性关节炎。患者通常表现为红斑丘疹和脓疱，这些病变会迅速发展为疼痛性溃疡，最常累及下肢。在本病例报告中，我们描述了一名57岁女性患者，患有多药难治性坏疽性脓皮病，病变局限于左小腿下部。根据临床和组织病理学特征确诊，皮肤活检显示出相符的结果。初始治疗，包括局部治疗（强效类固醇、氨苯砜和钙调神经磷酸酶抑制剂）和传统的全身免疫抑制治疗（皮质类固醇和肿瘤坏死因子抑制剂），均未能产生显著改善。然而，使用白细胞介素-23抑制剂司库奇尤单抗进行治疗，在几周内使溃疡大量愈合，并最终实现完全消退。
