ABSTRACT

Pyoderma gangrenosum (PG) is a rare, ulcerative lesion with inflammatory border and necrotic base, painful cutenous condition. Most frequently, it affects the lower extremities or the trunk. Fifty percent of the patients is associated with an underlying systemic disease, most commonly ulcerative colitis, Crohn’s disease, arthritis, monoclonal gammopathy and lymphoproliferative disorders. Both the aetiology and the pathogenesis of PG are poorly understood. There is no specific and uniformly effective therapy for the disease. There are a few controlled trials of the treatment for PG in the literature because it is a relatively rare disease. Topical treatment with steroids may be tried for milder forms but systemic steroids and/or cyclosporine A are the first choice in the advenced forms. Infliximab, a chimeric monoclonal antibody, inhibits TNF-alpha. Here, we present a case of 31-year-old male patient with idiopathic PG to refractory to the various topical agents and systemic steroid, cyclosporin A and methotrexate treatments, which showed a rapidly and successfully response to intravenous infliximab treatment.