Successful treatment of refractory pyoderma gangrenosum with risankizumab in a 57-year-old patient: A case report

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...

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Main Authors: Damy Horth, Nora Assouyat, Isabelle Auger
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:SAGE Open Medical Case Reports
Online Access:https://doi.org/10.1177/2050313X251352130
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author Damy Horth
Nora Assouyat
Isabelle Auger
author_facet Damy Horth
Nora Assouyat
Isabelle Auger
author_sort Damy Horth
collection DOAJ
description 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.
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spelling doaj-art-a1f2187a1ecd46f091d067e3d501aa1f2025-08-20T02:10:09ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2025-06-011310.1177/2050313X251352130Successful treatment of refractory pyoderma gangrenosum with risankizumab in a 57-year-old patient: A case reportDamy Horth0Nora Assouyat1Isabelle Auger2Department of Dermatology, Université Laval, Québec, QC, CanadaDepartment of Medicine, Université Laval, Québec, QC, CanadaDepartment of Dermatology, Université Laval, Québec, QC, CanadaPyoderma 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.https://doi.org/10.1177/2050313X251352130
spellingShingle Damy Horth
Nora Assouyat
Isabelle Auger
Successful treatment of refractory pyoderma gangrenosum with risankizumab in a 57-year-old patient: A case report
SAGE Open Medical Case Reports
title Successful treatment of refractory pyoderma gangrenosum with risankizumab in a 57-year-old patient: A case report
title_full Successful treatment of refractory pyoderma gangrenosum with risankizumab in a 57-year-old patient: A case report
title_fullStr Successful treatment of refractory pyoderma gangrenosum with risankizumab in a 57-year-old patient: A case report
title_full_unstemmed Successful treatment of refractory pyoderma gangrenosum with risankizumab in a 57-year-old patient: A case report
title_short Successful treatment of refractory pyoderma gangrenosum with risankizumab in a 57-year-old patient: A case report
title_sort successful treatment of refractory pyoderma gangrenosum with risankizumab in a 57 year old patient a case report
url https://doi.org/10.1177/2050313X251352130
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AT isabelleauger successfultreatmentofrefractorypyodermagangrenosumwithrisankizumabina57yearoldpatientacasereport