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Infliximab for peristomal pyoderma gangrenosum

Authors

  • D. Mimouni,

    1. Department of Dermatology, Johns Hopkins University School of Medicine, 720 Rutland Ave, Ross Building, Suite 771, Baltimore, MD 21205, U.S.A.
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  • G.J. Anhalt,

    1. Department of Dermatology, Johns Hopkins University School of Medicine, 720 Rutland Ave, Ross Building, Suite 771, Baltimore, MD 21205, U.S.A.
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  • D.J. Kouba,

    1. Department of Dermatology, Johns Hopkins University School of Medicine, 720 Rutland Ave, Ross Building, Suite 771, Baltimore, MD 21205, U.S.A.
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  • H.C. Nousari

    1. Department of Dermatology, Johns Hopkins University School of Medicine, 720 Rutland Ave, Ross Building, Suite 771, Baltimore, MD 21205, U.S.A.
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H.Carlos Nousari.
E-mail: hnousar@jhmi.edu

Abstract

Summary Peristomal pyoderma gangrenosum (PPG) is a variant of pyoderma gangrenosum (PG) that is more refractory to treatment. It is a cause of severe morbidity and poses a therapeutic challenge for the clinician. Infliximab (Remicade®; Centocor, Malvern, PA, USA) is a chimeric monoclonal antibody directed against tumour necrosis factor-α that has been proven to be effective in the treatment of inflammatory bowel disease (IBD) and rheumatoid arthritis. Currently, very few reports exist documenting its use in the treatment of PG and none in the treatment of PPG. We describe our experience of treating three patients with IBD-associated PPG with infliximab. All patients tolerated the drug without significant side-effects. Two patients with PPG recovered completely following the administration of infliximab, and one patient had a partial response to the drug. We conclude that infliximab appears to be a safe and effective therapeutic alternative in patients with PPG.

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