Pyoderma Gangrenosum in a Patient with Crohn’s Disease Treated with Adalimumab: A Case-Based Review and Systematic Review of the Current Literature

<b>Background:</b> 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...

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Main Authors: Fotios S. Fousekis, Konstantinos Mpakogiannis, Emmanouil Karampinis, Ioanna Nefeli Mastorogianni, Dimitrios K. Christodoulou, Marina Papoutsaki, Evanthia Zampeli, Konstantinos H. Katsanos
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Language:English
Published: MDPI AG 2025-03-01
Series:Clinics and Practice
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Online Access:https://www.mdpi.com/2039-7283/15/3/57
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author Fotios S. Fousekis
Konstantinos Mpakogiannis
Emmanouil Karampinis
Ioanna Nefeli Mastorogianni
Dimitrios K. Christodoulou
Marina Papoutsaki
Evanthia Zampeli
Konstantinos H. Katsanos
author_facet Fotios S. Fousekis
Konstantinos Mpakogiannis
Emmanouil Karampinis
Ioanna Nefeli Mastorogianni
Dimitrios K. Christodoulou
Marina Papoutsaki
Evanthia Zampeli
Konstantinos H. Katsanos
author_sort Fotios S. Fousekis
collection DOAJ
description <b>Background:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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. <b>Conclusions:</b> 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.
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spelling doaj-art-be407fe91d8c4d13a7cbde46ea779a202025-08-20T02:42:36ZengMDPI AGClinics and Practice2039-72832025-03-011535710.3390/clinpract15030057Pyoderma Gangrenosum in a Patient with Crohn’s Disease Treated with Adalimumab: A Case-Based Review and Systematic Review of the Current LiteratureFotios S. Fousekis0Konstantinos Mpakogiannis1Emmanouil Karampinis2Ioanna Nefeli Mastorogianni3Dimitrios K. Christodoulou4Marina Papoutsaki5Evanthia Zampeli6Konstantinos H. Katsanos7Department of Gastroenterology and Hepatology, University Hospital of Ioannina, University of Ioannina, 45110 Ioannina, GreeceDepartment of Gastroenterology and Hepatology, University Hospital of Ioannina, University of Ioannina, 45110 Ioannina, GreeceSecond Dermatology Department, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceDepartment of Gastroenterology and Hepatology, University Hospital of Ioannina, University of Ioannina, 45110 Ioannina, GreeceDepartment of Gastroenterology and Hepatology, University Hospital of Ioannina, University of Ioannina, 45110 Ioannina, Greece1st Departament of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, “A. Sygros” Hospital for Skin and Venereal Diseases, 16121 Athens, GreeceDepartment of Gastroenterology, Alexandra General Hospital, 11528 Athens, GreeceDepartment of Gastroenterology and Hepatology, University Hospital of Ioannina, University of Ioannina, 45110 Ioannina, Greece<b>Background:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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. <b>Conclusions:</b> 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.https://www.mdpi.com/2039-7283/15/3/57pyoderma gangrenosumCrohn’s diseaseadalimumabinflammatory bowel diseaseextra-intestinal manifestations
spellingShingle Fotios S. Fousekis
Konstantinos Mpakogiannis
Emmanouil Karampinis
Ioanna Nefeli Mastorogianni
Dimitrios K. Christodoulou
Marina Papoutsaki
Evanthia Zampeli
Konstantinos H. Katsanos
Pyoderma Gangrenosum in a Patient with Crohn’s Disease Treated with Adalimumab: A Case-Based Review and Systematic Review of the Current Literature
Clinics and Practice
pyoderma gangrenosum
Crohn’s disease
adalimumab
inflammatory bowel disease
extra-intestinal manifestations
title Pyoderma Gangrenosum in a Patient with Crohn’s Disease Treated with Adalimumab: A Case-Based Review and Systematic Review of the Current Literature
title_full Pyoderma Gangrenosum in a Patient with Crohn’s Disease Treated with Adalimumab: A Case-Based Review and Systematic Review of the Current Literature
title_fullStr Pyoderma Gangrenosum in a Patient with Crohn’s Disease Treated with Adalimumab: A Case-Based Review and Systematic Review of the Current Literature
title_full_unstemmed Pyoderma Gangrenosum in a Patient with Crohn’s Disease Treated with Adalimumab: A Case-Based Review and Systematic Review of the Current Literature
title_short Pyoderma Gangrenosum in a Patient with Crohn’s Disease Treated with Adalimumab: A Case-Based Review and Systematic Review of the Current Literature
title_sort pyoderma gangrenosum in a patient with crohn s disease treated with adalimumab a case based review and systematic review of the current literature
topic pyoderma gangrenosum
Crohn’s disease
adalimumab
inflammatory bowel disease
extra-intestinal manifestations
url https://www.mdpi.com/2039-7283/15/3/57
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