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DOI: 10.1177/1534734607300912 Improvement of Idiopathic Pyoderma Gangrenosum During Treatment With Anti-Tumor Necrosis Factor Alfa Monoclonal AntibodyWound Healing Research Unit, Department of Dermatology, University of Pisa, Pisa, Italy
Wound Healing Research Unit, Department of Dermatology, University of Pisa, Pisa, Italy, m.romanelli{at}med.unipi.it
Wound Healing Research Unit, Department of Dermatology, University of Pisa, Pisa, Italy
Department of Rheumatology, University of Pisa, Pisa, Italy
Department of Rheumatology, University of Pisa, Pisa, Italy
Wound Healing Research Unit, Department of Dermatology, University of Pisa, Pisa, Italy
Pyoderma gangrenosum (PG) is an inflammatory ulcerative condition of unknown etiology. An autoimmune mechanism including immune complexmediated neutrophilic vascular reactions has been suggested. The role of tumor necrosis factor (TNF) in PG remains unclear. Evidence supports the idea that TNF plays a role in chronic inflammation and migration of neutrophils to these lesions. PG is frequently associated with various diseases, but up to 50% of cases are idiopathic. There are several reports describing the successful use of infliximabTM (Remicade ®, Centocor, Inc, Horsham, Pa), a chimeric antitumor necrosis factor
Key Words: pyoderma gangrenosum infliximabTM leg ulcers anti-TNF alfa
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monoclonal antibody, in the treatment of inflammatory bowel disease associated PG, but there have been few reported cases of infliximab in the treatment of idiopathic PG. The authors present a dramatic improvement in 4 cases of idiopathic PG of the lower leg treated with infliximab.