Recalcitrant Pyoderma Gangrenosum and Subcorneal Pustular Dermatosis Successfully Treated With Adalimumab

Hijas, M.C. García del Pozo-Martín de; Agudo-Mena, José Luis; Sánchez, María Encarnación Gómez; Escario-Travesedo, E.

doi:10.1016/j.adengl.2020.10.018

Cited by 3 publications

(4 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another differential diagnosis for case 3 was pustular PG, a subtype of PG 23 . As pustular PG is usually associated with inflammatory bowel disease, 24 and since previous reports often describe subcorneal pustules associated with PG as SPD, 9,19 we diagnosed the case as SPD.…”

Section: Discussionmentioning

confidence: 99%

“…Case 2 may also have been SPD as a paradoxical skin reaction due to adalimumab. On the other hand, SPD has been reported to be successfully treated with adalimumab, 18,19 and the involvement of tumor necrosis factor inhibitors in SPD varies depending on each case. The clinical presentation of case 2 was mainly solitary pustules without a typical annular pattern.…”

Section: Case 2 Could Have Been Triggered By the Flu Vaccination Ormentioning

confidence: 99%

See 1 more Smart Citation

Three cases of subcorneal pustular dermatosis with immunohistochemical examinations

Kishimoto

Komine

Okada

et al. 2023

The Journal of Dermatology

View full text Add to dashboard Cite

Subcorneal pustular dermatosis, a rare, benign skin disease, is a type of neutrophilic dermatosis. The authors reported three cases of subcorneal pustular dermatosis. In case 1, a 9‐year‐old girl developed a skin rash with blisters following a mycoplasma infection and had a flare‐up due to a common cold. She was successfully treated with a topical corticosteroid. In case 2, a 70‐year‐old woman who had been treated for rheumatoid arthritis with adalimumab, salazosulfapyridine, and leflunomide developed 3‐ to 5‐mm pustules on her trunk and thighs 4 days after flu vaccination. The rash disappeared with drug withdrawal and treatment with diaminodiphenyl sulfone. In case 3, an 81‐year‐old man, who was diagnosed with pyoderma gangrenosum at 61 years old, developed multiple small flaccid pustules on his trunk and extremities due to an infection in the arteriovenous shunt area on the forearm. The pustule disappeared with intravenous antibiotic therapy; however, the pustules subsequently flared up along with ulcers typical of pyoderma gangrenosum. He was given oral prednisolone therapy, which was effective for the small pustules and some ulcers. Immunohistochemical examination of the three cases revealed neutrophilic infiltration in the subcorneal layer of the epidermis. The pustules contained neutrophils as well as some CD68+ and a few CD1a+ cells. The epidermis and dermis were more predominantly infiltrated by CD4+ cells than by CD8+ cells. Positive stainings for interleukin 8, interleukin 36γ, and phospho‐extracellular signal‐regulated kinases 1 and 2 were observed in the upper layers of the epidermis below the pustules. Although the pathogenesis of subcorneal pustular dermatosis has not been clarified, the current results suggest that a variety of inflammatory cells, including those responsible for both innate and acquired immunity, are involved in the accumulation of neutrophils in subcorneal pustular dermatosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Case 2 Could Have Been Triggered By the Flu Vaccination Ormentioning

confidence: 99%

Three cases of subcorneal pustular dermatosis with immunohistochemical examinations

Kishimoto

Komine

Okada

et al. 2023

The Journal of Dermatology

View full text Add to dashboard Cite

show abstract

“…Several studies demonstrate the efficacy of adalimumab, infliximab, and etanercept in the treatment of pyoderma gangrenosum. [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.…”

Section: Neutrophilic Dermatosesmentioning

confidence: 99%

“…Several studies demonstrate the efficacy of adalimumab, infliximab, and etanercept in the treatment of pyoderma gangrenosum 51–53 …”

Section: Eosinophilic Dermatosismentioning

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

View full text Add to dashboard Cite

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.

show abstract

Successful Treatment of Severe Subcorneal Pustular Dermatosis with Adalimumab

Chen¹,

Luo²,

Yu³

et al. 2022

CCID

View full text Add to dashboard Cite

Subcorneal pustular dermatosis (SPD) is a rare, chronic pustular dermatosis. The pathogenesis of SPD has not been fully elucidated, but some studies have found that tumor necrosis factor (TNF)-α may be associated with its pathogenesis. Some patients with multidrug-resistant SPD have improved significantly after treatment with the anti-TNF-α agent (adalimumab). We present a case of a 28-year-old female with severe SPD who responded rapidly to adalimumab (80mg/week) in combination with acitretin and methylprednisolone within a week. With adalimumab (40 mg next week and followed by 40mg every two weeks) and gradually ceasing other systemic medication, the patient's condition continued to improve without relapse or side effects. The outcome of this case suggests that adalimumab might be an effective treatment option against multidrug-resistant SPD.

show abstract

Recalcitrant Pyoderma Gangrenosum and Subcorneal Pustular Dermatosis Successfully Treated With Adalimumab

Cited by 3 publications

References 8 publications

Three cases of subcorneal pustular dermatosis with immunohistochemical examinations

Three cases of subcorneal pustular dermatosis with immunohistochemical examinations

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

Successful Treatment of Severe Subcorneal Pustular Dermatosis with Adalimumab

Contact Info

Product

Resources

About