Pyoderma gangrenosum possibly triggered by adalimumab

Kikuchi, Nobuyuki; Hiraiwa, Tomoko; Ohashi, Takenobu; Hanami, Yuka; Satoh, Masataka; Takenoshita, Hideo; Yamamoto, Toshiyuki

doi:10.1684/ejd.2012.1849

Cited by 18 publications

(10 citation statements)

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“…Cases of drug‐induced PG were mainly gathered from PubMed searches using a variety of combined search terms including ‘pyoderma gangrenosum’, ‘drug‐induced pyoderma gangrenosum’, ‘neutrophilic dermatosis’, ‘treatment’ and ‘therapy’. A list of cases of drug‐induced PG is provided in Table and the proposed pathogenic mechanisms for each drug are illustrated in Figure .…”

Section: Summary Of Each Of the 43 Published Reports Of Drug‐induced mentioning

confidence: 99%

Drug-induced pyoderma gangrenosum: a model to understand the pathogenesis of pyoderma gangrenosum

Patel

Ortega‐Loayza

2017

Br J Dermatol

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This study aimed to explore how drug-induced pyoderma gangrenosum develops in the body. Pyoderma gangreno-sum (PG) is a rare autoinflammatory disease (a genetic disease caused by a malfunctioning immune system) that causes tissue cells to die, resulting in severe and painful ulcers. Drug-induced disease is where a disease occurs, or is triggered, as a result of taking medication/drugs. In this study 43 cases of patients diagnosed with drug-induced PG were reviewed. The authors found that most of the medications associated with drug-induced PG affected more the one element in the pathway that leads to a person developing drug-induced PG. Abnormal neutrophil migration and function, dysregulated inflammation, keratinocyte apoptosis, and alteration of epigenetic mechanisms were all found to be associated with the development of drug-induced PG. Abnormal neutrophil migration and function refers to the irregular movement and function of a specific type of white blood cell (which forms part of the body's immune system). Dysregulated inflammation refers to an abnormal inflammation response in the body's cells and tissue. Ker-atinocyte apoptosis means the death of keratinocyte cells (the cells that form the majority of the outer layer of skin). Alteration of epigenetic mechanisms means a change to the way in which a cell reads and understands its own genes, which in turn affects how the cell behaves. The authors conclude that, in order to better understand how PG develops, further research is needed into the immune system, epigenetics (the way in which a cell reads and acts upon its genes) and NETosis (a form of cell death).

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Section: Summary Of Each Of the 43 Published Reports Of Drug‐induced mentioning

confidence: 99%

Drug-induced pyoderma gangrenosum: a model to understand the pathogenesis of pyoderma gangrenosum

Patel

Ortega‐Loayza

2017

Br J Dermatol

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“…[51][52][53] The paradoxical occurrence of pyoderma gangrenosum has been reported after the use of all TNF-α inhibitors. [54][55][56][57][58] Regarding the time interval of lesions, most patients developed symptoms after 3-6 months. However, a period of up to 48 months has also been reported.…”

Section: Neutrophilic Dermatosesmentioning

confidence: 99%

Paradoxical and bimodal immune‐mediated dermatological side effects of TNF‐α inhibitors: A comprehensive review

Behrangi,

Moodi,

Jafarzadeh

et al. 2024

Skin Research and Technology

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IntroductionDue to the increasing prevalence of immune‐mediated diseases such as psoriasis, lichen planus, rheumatoid arthritis and inflammatory bowel disease, dermatologists have turned to new biologic drugs known as DMARDs (disease‐modifying anti‐rheumatic drugs) in recent years.Areas CoveredIn this study, we evaluate the immune‐mediated dermatological side effects of DMARDS by reviewing and analyzing previous peer‐reviewed research on the effects of TNF‐α inhibitors in the treatment of skin diseases, as well as adverse effects of these drugs and some of the main causes of these effects.Expert OpinionDMARDs are very effective in improving control of the above diseases. TNF‐α inhibitors are an important group of DMARDs that are widely used. The paradoxical adverse events (PAEs) associated with the use of TNF‐α inhibitors are divided into three categories: true paradoxical, borderline paradoxical, and non‐paradoxical. True PAEs include conditions for which TNF‐α inhibitors are approved for treatment. Borderline PAEs are considered to occur with this class of drugs for which there is no definite approval but for which there is sufficient evidence. Although these events are rare, early recognition of the accused drug and appropriate decision‐making may prevent progression of complications and irreversible side effects.

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“…26 Recently, there have been sporadic reports of induction of PG due to a paradoxical reaction to biological preparations or during the administration of immune checkpoint inhibitors. [27][28][29][30][31]…”

Section: Drug-induced Pyoderma Gangrenosummentioning

confidence: 99%

“…Propylthiouracil, along with phorbol ester, induces neutrophil extracellular traps (NETs), and levamisole and cocaine also act on neutrophils and induce cell death accompanied by NETs (NETosis) 26 . Recently, there have been sporadic reports of induction of PG due to a paradoxical reaction to biological preparations or during the administration of immune checkpoint inhibitors 27–31 …”

Section: Clinical Features Of Pyoderma Gangrenosummentioning

confidence: 99%

Clinical guidance of pyoderma gangrenosum 2022

Yamamoto

Yamasaki

Yamanaka

et al. 2023

The Journal of Dermatology

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Pyoderma gangrenosum (PG) is a rare, neutrophilic skin disease. For the purpose of accurate diagnosis and proper treatment of PG, the Japanese clinical practice guidance for PG developed by the Japanese Dermatological Association was published in 2022. In this guidance, clinical aspects, pathogenesis, current therapies, and clinical questions on PG are described from the viewpoints of current knowledge and evidence‐based medicine. Here, the English version of the Japanese clinical practice guidelines for PG is presented and is intended to be widely referred to in the clinical examination and treatment of PG.

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Pyoderma gangrenosum possibly triggered by adalimumab

Cited by 18 publications

References 0 publications

Drug-induced pyoderma gangrenosum: a model to understand the pathogenesis of pyoderma gangrenosum

Drug-induced pyoderma gangrenosum: a model to understand the pathogenesis of pyoderma gangrenosum

Paradoxical and bimodal immune‐mediated dermatological side effects of TNF‐α inhibitors: A comprehensive review

Clinical guidance of pyoderma gangrenosum 2022

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