Corticosteroid-Resistant Pyoderma gangrenosum Associated with Crohn’s Disease: Rapid Cure with Infliximab

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Abstract
A 41-year-old woman with Crohn’s disease had a severe and rapidly extensive corticosteroid-resistant pyoderma gangrenosum (PG) of the leg. She had been treated 2 years previously with antibiotics and surgery for a similar lesion of the back of the hand which had been diagnosed as a fulminating infection. Infliximab 5 mg/kg was given at weeks 0, 5 and 9. A dramatic response was observed within 72 h with a favourable effect persisting for 4 weeks after each infliximab infusion. A complete healing was achieved at week 11. This case illustrates that (1) PG of the hand is frequently misdiagnosed as an infection and treated with inappropriate therapies; (2) infliximab may be an interesting alternative in corticosteroid-resistant PG associated with Crohn’s disease.