Adalimumab Therapy for Recalcitrant Pyoderma Gangrenosum

Objective: To describe a patient with treatment-refractory pyoderma gangrenosum and the outcome of a novel therapeutic approach. Methods: Case report and review of the literature. Results: A patient with inflammatory bowel disease developed severe pyoderma gangrenosum while receiving treatment with the chimeric anti-TNF-α antibody infliximab. Despite subsequent trials of numerous immunosuppressive and immunomodulatory medications, the dermatologic disease progressed. The patient's ulcers finally resolved when treatment with adalimumab, a fully humanized monoclonal antibody specific for TNF-α, was initiated. Conclusions: We report a novel application of the TNF-α inhibitor, adalimumab, in the treatment of pyoderma gangrenosum.