Successful Use of Adalimumab for Treating Pyoderma Gangrenosum with Ulcerative Colitis under Corticosteroid-tapering Conditions

Intern Med. 2015;54(17):2167-72. doi: 10.2169/internalmedicine.54.4853. Epub 2015 Sep 1.

Abstract

A 52-year-old woman with ulcerative colitis was admitted to our hospital for an ulcerative colitis flare-up under salazosulfapyridine therapy. The symptoms improved with high-dose corticosteroids. After prednisolone was tapered to 10 mg, the frequency of diarrhea increased. The diarrhea was accompanied by joint pain and a skin ulcer with abscess formation, which was diagnosed to be pyoderma gangrenosum. The patient was started on adalimumab. A positive response to the adalimumab therapy was observed after 2 weeks, during which time the ulcerative skin lesion healed completely, however, colonic mucosal healing was achieved at 2 months. Therefore, adalimumab appears to be an effective therapeutic option for patients with ulcerative colitis-associated pyoderma gangrenosum.

Publication types

  • Case Reports

MeSH terms

  • Adalimumab / administration & dosage
  • Adalimumab / therapeutic use*
  • Adrenal Cortex Hormones / administration & dosage*
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / therapeutic use*
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Colitis, Ulcerative / complications
  • Colitis, Ulcerative / drug therapy*
  • Female
  • Humans
  • Middle Aged
  • Prednisolone / administration & dosage*
  • Pyoderma Gangrenosum / drug therapy*
  • Pyoderma Gangrenosum / etiology
  • Skin Ulcer / complications
  • Skin Ulcer / drug therapy*
  • Skin Ulcer / pathology
  • Sulfasalazine / administration & dosage
  • Treatment Failure
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Sulfasalazine
  • Prednisolone
  • Adalimumab