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Pyoderma gangrenosum associated with chronic refractory pouchitis: a case successfully treated with infliximab

Authors
  • Koumaki, Dimitra1
  • Orfanoudaki, Eleni2
  • Machaira, Angeliki2
  • Lagoudaki, Eleni3
  • Krasagakis, Konstantinos1
  • Koutroubakis, Ioannis E.2
  • 1 Department of Dermatology (Dimitra Koumaki, Konstantinos Krasagakis)
  • 2 Department of Gastroenterology (Eleni Orfanoudaki, Angeliki Machaira, Ioannis E. Koutroubakis)
  • 3 Department of Pathology (Eleni Lagoudaki), University Hospital of Heraklion, Crete, Greece
Type
Published Article
Journal
Annals of Gastroenterology
Publisher
Hellenic Society of Gastroenterology
Publication Date
May 28, 2020
Volume
33
Issue
4
Pages
433–435
Identifiers
DOI: 10.20524/aog.2020.0500
PMID: 32624666
PMCID: PMC7315701
Source
PubMed Central
Keywords
License
Green

Abstract

Pouchitis-associated pyoderma gangrenosum (PG) is rare, with only a few cases reported in the literature. Here we report a rare case of chronic refractory pouchitis-associated PG successfully treated with infliximab (IFX). A 43-year-old Caucasian male, with a past medical history of chronic refractory pouchitis after proctocolectomy and ileal pouch-anal anastomosis for severe ulcerative colitis, developed PG on his right lower leg. This subsided after treatment with intravenous IFX at a dose of 5 mg/kg at weeks 0, 2, 6 and then every 8 weeks. Pouchitis-associated PG is rare. Clinicians should be aware of the risk of PG in patients who suffer from pouchitis and develop rapidly extensive painful ulcers. Furthermore, the therapeutic choice should take into consideration the effectiveness of IFX on the inflammatory background, which sustains both intestinal and skin disease in these types of patients.

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