RARE DISEASE
Pyoderma gangrenosum
Pyoderma gangrenosum
Pyoderma gangrenosum
Drug discovery
6
drugs
With orphan designations
Overview
Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by rapidly progressive, painful ulcerations with violaceous undermined borders. It manifests through dysregulated innate immunity, often associated with systemic conditions (e.g., inflammatory bowel disease, arthritis) in 30-50% of cases [1][4][6]. Diagnosis remains clinical after excluding infectious/vascular causes [15][16], with treatment focusing on immunosuppression and advanced wound care [3][6][8].
Therapies
Mild: High-potency topical steroids (clobetasol), tacrolimus, antimicrobial dressings [3][6][18]
Moderate-severe: Systemic corticosteroids, cyclosporine, TNF-α inhibitors (infliximab/adalimumab) [3][8][13]
Adjuvant care: Pain management, avoidance of trauma/pathergy, staged surgical repair post-remission [1][6][18]
Categories: rare skin diseases, rare systemic and rheumatological diseases
Research Papers
1,398 drug discovery papers about Pyoderma gangrenosum, with 2 first-in-class and 7 next-in-class emerging drug candidates forecasted to outperform the average preclinical success rate. Recent publications:
1,398 drug discovery papers about Pyoderma gangrenosum, with 2 first-in-class and 7 next-in-class emerging drug candidates forecasted to outperform the average preclinical success rate. Recent publications:
categories:
Small molecules
small molecules
2026-08-16 | NLRP3 inflammasome activation is associated with type 1 inflammation and neutrophil activation in pyoderma gangrenosum across human and murine models.
Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by painful, nonhealing cutaneous ulcers. Although dysregulated innate immunity and neutrophil activation are implicated in its pathogenesis, the underlying molecular mechanisms remain poorly defined. This study aimed to identify conserved pathogenic mechanisms by integrating analyses of human PG lesions and a brequinar-induced PG-like murine model and to assess therapeutic relevance. Skin biopsy specimens from patients with PG and publicly available RNA-sequencing data were analyzed alongside the murine model using histological and transcriptomic approaches. Cross-species transcriptomic integration identified shared inflammatory pathways between human and murine PG. Human PG lesions showed increased neutrophil infiltration, neutrophil extracellular trap formation, and a dominant type 1 inflammatory profile, all of which were recapitulated in the brequinar-induced mouse model, together with impaired wound healing. Transcriptomic analyses revealed enhanced oxidative stress responses and activation of the NLRP3/caspase-1 inflammasome pathway as a conserved pathogenic axis. In the murine model, both prednisolone and avacopan suppressed inflammatory cytokine expression and neutrophil activation; however, only avacopan significantly improved wound healing. Collectively, these findings suggest that NLRP3 inflammasome activation is associated with type 1 inflammation and neutrophil extracellular trap formation and may represent a PG-associated inflammatory pathway.
2026-08-15 | Preliminary exploration of effects of the JAK inhibitor tofacitinib on pyoderma gangrenosum: In vitro inhibition of NETs and Th17 differentiation.
Pyoderma gangrenosum (PG), a refractory inflammatory disorder, remains a condition with incompletely understood pathogenesis. Currently, no FDA-approved treatments are available. Janus kinase (JAK) inhibitors have been reported sporadically in case studies as effective treatments for PG. To characterize the cellular and molecular landscape associated with JAK/STAT (signal transducer and activator of transcription) pathway overactivation in PG lesions, and investigate the potential effects of tofacitinib on PG. Single-cell RNA sequencing (scRNA-seq) and multiplex immunohistochemistry (mIHC) were employed to characterize the cellular and molecular landscape of JAK/STAT pathway overactivation in PG. In vitro experiments (immunostaining, qPCR, western blot, flow cytometry) were performed to further validate the potential effects of tofacitinib on PG. We identified significant overactivation of the JAK/STAT pathway in PG lesions-particularly in advanced stages-which, in terms of immune inflammation, is primarily driven by myeloid cells and T cells. This activation was associated with enhanced neutrophil extracellular trap (NET) formation in myeloid cells and aberrant differentiation/plasticity of Th17 and Th17.1 (IL-17/IFN-γ double-producing) cells. In vitro cell experiments further demonstrated that the JAK inhibitor tofacitinib suppresses STAT phosphorylation in myeloid and T cells, myeloid NETosis, and IL-17A production. Our study investigated immunological profiling of PG lesions via scRNA-seq and mIHC, along with in vitro validation. These findings delineate a multi-axis cellular and molecular landscape of PG linked to aberrant JAK/STAT signaling, and provide preliminary in vitro evidence supporting potential inhibitory effects of tofacitinib on key pathological processes of PG.
2026-08-03 | Dual-Site Postsurgical Pyoderma Gangrenosum of the Breast and Back With Delayed Diagnosis: A Case Report
Objective: Unusual clinical course Background:Postsurgical pyoderma gangrenosum is a rare neutrophilic dermatosis that can mimic infection, wound dehiscence, malignancy, foreign-body reaction, or impaired surgical healing.Diagnostic delay is common and may lead to repeated debridement, which can worsen ulceration through pathergy.This case highlights the diagnostic challenge of multifocal postsurgical pyoderma gangrenosum involving anatomically distinct sites after procedures initially performed for presumed benign lesions. Case Report:A 70-year-old woman with celiac disease and prior left breast cancer treated with lumpectomy, chemotherapy, radiation, and implant reconstruction developed nonhealing ulcers of the left superior breast and left lower back after surgical treatment of benign lesions.Initial evaluation favored retained cyst lining, foreign-body reaction, infection, impaired wound healing, and possible implant-related complications.Despite advanced wound therapies, antimicrobials, and biologic wound products, both lesions progressively enlarged.Biopsies demonstrated abscess formation, multinucleated giant cells, and sinus tract formation without malignancy.Wound cultures and pulmonary findings complicated the diagnostic course, but neither targeted antimicrobial nor prolonged antifungal therapy produced sustained improvement.The diagnosis was clinically supported by worsening after procedural intervention, exclusion of malignancy and persistent infection, multifocal involvement, and rapid response after initiation of topical and intralesional corticosteroid therapy. Conclusions:This case supports considering postsurgical pyoderma gangrenosum in refractory postsurgical wounds that worsen despite local wound-directed interventions, particularly when lesions involve multiple anatomically distinct surgical sites.The complete resolution of both lesions after topical and intralesional corticosteroid therapy further supports the importance of recognizing an inflammatory, pathergy-driven process once infection, malignancy, and other local causes have been reasonably excluded.Earlier recognition may help avoid repeated procedural trauma, unnecessary treatment escalation, and prolonged morbidity.
2026-08-03 | Postoperative Pyoderma Gangrenosum Following Varicose Vein Surgery: Recognizing a Rare Surgical Mimic Before Extensive Tissue Loss.
Postoperative pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis that frequently masquerades as a surgical site infection. Because its clinical presentation closely resembles postoperative cellulitis or even necrotizing soft tissue infection, diagnosis is often delayed. Misdiagnosis may result in unnecessary antibiotic escalation, repeated surgical interventions, and progressive tissue destruction due to pathergy. This case highlights the importance of early recognition of PG and serves as a reminder for surgeons to consider this uncommon diagnosis when postoperative wounds fail to respond to conventional treatment. A 75-year-old woman underwent elective open varicose vein surgery (ligation of neocrosse veins and phlebectomies) for recurrent symptomatic varicose veins of the left lower limb. One week postoperatively, she developed a painful erythematous wound that was initially diagnosed as a surgical site infection. Despite drainage, repeated wound care, and escalation from oral to broad-spectrum intravenous antibiotic therapy, the lesion rapidly progressed into an extensive necrotic ulcer. Repeated wound cultures and blood cultures remained sterile, while computed tomography scans demonstrated inflammatory changes without evidence of a drainable collection or necrotizing soft tissue infection. Following dermatological consultation, postoperative PG was suspected and confirmed by skin biopsy. High-dose systemic corticosteroid therapy was initiated, resulting in rapid clinical improvement, cessation of ulcer progression, and subsequent wound healing. This case illustrates the diagnostic challenge of postoperative PG and emphasizes several clinical features that should prompt reconsideration of a presumed surgical site infection, including disproportionate pain, rapidly progressive ulceration, sterile cultures, failure of appropriate antimicrobial therapy, and inconclusive imaging findings. Early recognition is essential, as surgical manipulation may exacerbate disease progression through pathergy. Postoperative PG should be considered in any patient presenting with a rapidly progressive postoperative wound that fails to improve despite appropriate antimicrobial treatment. Increased awareness among surgeons may facilitate earlier diagnosis, prevent unnecessary surgical procedures, and reduce the risk of extensive tissue loss.
2026-07-24 | Recurrence after healing in pyoderma gangrenosum: a prospective registry-based cohort study.
Pyoderma gangrenosum is a rare neutrophilic dermatosis with potential for relapse after healing, yet recurrence in real-world settings remains unknown. We aimed to evaluate recurrence patterns to inform clinical practice and future research. Data were abstracted from a uniquely, prospectively maintained pyoderma gangrenosum registry. A cohort of patients with pyoderma gangrenosum seen between December 1st, 2019 and March 1st, 2026 who healed within this timeframe was identified. Two subgroups were then created: those who remained healed, and those who had a recurrence. Descriptive statistics summarised recurrence characteristics; Kaplan-Meier methods estimated a cumulative incidence of recurrence, and Cox proportional hazards modelling identified predictors of recurrence. Of 116 patients with healed pyoderma gangrenosum, 41 (35%) experienced a recurrence, generating a recurrence proportion of 35·3% (95% CI 26·7-44·8). Nominal associations with recurrence on univariable analysis included history of diabetes mellitus (hazard ratio 2·1, 95% CI 1·1-4·0, p = 0·024) and ever-smoking (1·8, 1·0-3·4, p = 0·057). Baseline characteristics differing between recurrence and non-recurrence groups included age (p = 0·033), history of diabetes (p = 0·0060), and ulcer age at presentation (p = 0·046). Cumulative recurrence risk was calculated as 27% (95% CI 18·1-35·0) at 1 year and 41·3% (95% CI 30·4-50·5) at 5 years. Pyoderma gangrenosum recurred in approximately a third of patients. A history of diabetes showed a borderline association with recurrence, while the univariable signal for smoking was attenuated after adjustment. Recurrence risk remains elevated five years after initial healing, and peristomal pyoderma gangrenosum is associated with higher recurrence rates, suggesting that maintenance therapy may be necessary for certain patient populations after achieving ulcer closure. Our data highlight the need for prospective evaluation of maintenance approaches. Future work will focus on individual recurrence predictors. This is an unfunded study.
cell therapies
2026-04-14 | Multidisciplinary Approach to Complex Lower Extremity Limb Salvage in Pyogenic Arthritis, Pyoderma Gangrenosum, and Acne (PAPA) Syndrome: A Case Report.
Limb salvage using free tissue transfer in patients with rare autoinflammatory syndromes is poorly described, and the safety of microvascular reconstruction in this population remains uncertain. Hereditary pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome is characterized by dysregulated inflammation, pathergy, and impaired wound healing, raising concern for flap compromise and postoperative complications. We report a rare case of lower extremity free tissue transfer in a patient with PAPA syndrome. A 66-year-old woman with rheumatoid arthritis and PAPA syndrome presented with rapid wound breakdown, violaceous ulceration, exposed hardware, and periprosthetic joint infection following left total knee arthroplasty (TKA). Examination revealed an approximately 9 × 7 cm anterior knee defect with subtotal patellar tendon necrosis. After multidisciplinary optimization, she underwent single-stage irrigation and debridement, hardware removal, revision TKA with patellar tendon reconstruction using gracilis autograft, and immediate coverage with a 22 × 14 cm free latissimus dorsi (LD) muscle flap. The flap was anastomosed end-to-side to the anterior tibial artery with venous outflow via the venae comitantes and loosely inset to preserve future surgical access. The donor site was closed primarily. A 21 × 13 cm staged split-thickness skin graft was performed 1 week later, with adjunctive postoperative hyperbaric oxygen therapy (HBOT). Initial healing was uncomplicated, with complete graft take and donor-site healing. Four months postoperatively, the patient developed chronic sinus tracts and recurrent periprosthetic infection requiring flap re-elevation, debridement, and hardware exchange; the flap pedicle was preserved, and coverage maintained. At one-year follow-up, all wounds had healed; flap coverage was durable with acceptable cosmesis, and the patient was ambulatory for short distances without assistance. She was last seen infection-free and full-weightbearing 4 months later. This case demonstrates that microvascular limb salvage is feasible in PAPA syndrome when guided by multidisciplinary planning and strategic flap design.
2026-03-11 | The Use of Human Placental Allografts for Pyoderma Gangrenosum
Background/Objectives: Pyoderma gangrenosum (PG) is a rapidly progressive, ulcerating condition that can cause large, painful lesions when uncontrolled. There is currently no standard of care treatment for severe PG ulcers refractory to systemic treatment. The present study aims to characterize the outcomes of placental allografts in treating severe PG lesions. Methods: A single institution retrospective chart review was conducted at the University of South Florida affiliated sites examining PG patients that received placental allograft treatment. Results: The review returned five patients with clinically diagnosed or biopsy-proven PG treated with placental allograft. In all five patients, application of placental allograft resulted in varying degrees of short-term (<1 month) improvement. Near-complete resolution was observed in one patient. Out of the 20 total allografts placed between the 5 patients, only one had an adverse event of infection within one week of placement. Grafts were otherwise very well tolerated by all patients. Conclusions: Placental allografts show promising adjunctive therapeutic potential for severe PG lesions with preliminary findings showing good viability and safety profiles. Future prospective controlled studies should be performed to further examine the viability of this adjunctive treatment in this disease.
2025-08-06 | Larval Debridement Therapy for Management of Postsurgical Wounds in the Setting of Pyoderma Gangrenosum.
Pyoderma gangrenosum (PG) is a rare disease affecting 5.8 adults per 100,000 in the United States. PG is not exclusively seen in inflammatory bowel disease; however, among those with inflammatory bowel disease, upward of 0.4%-2% may have concomitant PG. Wounds in the setting of PG are a challenge for clinicians to treat, especially when refractory to first-line agents such as immunosuppressive agents and biologic therapy. Herein, we present the case of a patient with PG who underwent a colostomy reversal, developed a PG wound, and was successfully treated with larval debridement therapy (LDT). A 62-year-old man underwent elective reversal of his loop sigmoid colostomy. He had developed an anastomotic leak, requiring a descending colostomy and mesh removal. Ultimately, he developed a pyoderma wound at the previous ostomy site. Cyclosporine, prednisone, antibiotics, dressing changes, a single debridement, and biologic therapy failed to heal the wound. After 2 applications of LDT, the wound healed completely. Literature regarding LDT for nonhealing diabetic wounds and pressure ulcers is well described; however, its use for abdominal wounds in the setting of PG is not well documented. Most case reports on LDT for abdominal wounds discuss only a partial response with minimal to no wound healing. Unlike the previously published literature, our case report demonstrated complete wound response without decreased larvae survivability in the setting of previously administered immunosuppressants. LDT appears to be a viable option for patients who do not appropriately respond to first-line medical therapies for surgical wounds in the setting of PG.
2025-06-09 | PYODERMA GANGRENOSUM WITH NON-PSEUDOMONAL ECTHYMA GANGRENOSUM IN MYELODYSPLASTIC SYNDROME TREATED WITH ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION.
Co-occurrence of pyoderma gangrenosum (PG) and ecthyma gangrenosum (EG) pose diagnostic and therapeutic challenges in immunocompromised patients. A 47-year-old Filipino woman with transfusion-dependent intermediate-risk myelodysplastic syndrome (MDS) was admitted to our institution for allogeneic hematopoietic stem cell transplantation (HSCT). During the preparation for allogeneic HSCT, she developed several erythematous ulcerated lesions on the lower extremities, which were initially managed as PG. Subsequent febrile episodes and worsening lesions with isolated Escherichia coli in blood and tissue cultures lead to the diagnosis of EG complicating PG. She was treated through targeted antibiotics, wound debridement, and proper wound care. After the resolution of the infection and upon starting low-dose immunosuppression followed by allogeneic HSCT, her left leg lesions showed progressive improvement. Six months after HSCT, lesions were completely resolved with complete epithelialization. This case highlights the importance of accurate diagnosis and integrated management of complex conditions like PG and EG in immunocompromised patients. The successful resolution of lesions post-HSCT underscores the potential curative role of stem cell transplantation in managing MDS-associated PG.
2024-12-27 | The Striking Power of Amniotic Fluid and Its Exosomes Collected at the End of a Normal Pregnancy on Severe Inflammation and Tissue Repair.
With this short communication, which contains a new case report on diabetic ulcer, we summarize our research progress in treating several complex conditions at a point where currently available treatments were failing to help the affected patients. We review the first case of lower back pain due to severe spondylitis (T12-L1) treated with intravenous injections of a sterile fraction of human purified amniotic fluid (ViX001) obtained from thoroughly screened volunteers at the time of planned c-section at the term of normal pregnancies. Then, we review the first case of recalcitrant diabetic ulcer treated successfully by twice-daily applications of ViX001 directly on the wound and describe another case of diabetic ulcer treated successfully with ViX001. Next, we review the treatment of severe burns with direct application of ViX001 on the burns leading to accelerated improvement of the burn lesions. Finally, we review the first treatment of a patient with advanced pyoderma gangrenosum with ViX001, with significant reduction of pain, inflammation, and observation of tissue regeneration. We conclude our review with speculations on the mechanism of action of ViX001, the importance of extracellular vesicles in the amniotic fluid for its biological activity, and the need for expanding our studies to generate a better understanding of the omics signature of this incredibly beneficial material.
antibodies
2026-08-12 | Case Report: IVIG as a bridging strategy in high-risk antiphospholipid syndrome with infected cutaneous ulceration and thrombocytopenia.
Severe cutaneous ulceration in antiphospholipid syndrome (APS) with concurrent infection and thrombocytopenia presents a therapeutic dilemma: standard immunosuppression risks worsening infection, while anticoagulation risks hemorrhage. We present a high-risk case successfully managed using intravenous immunoglobulin (IVIG) as a bridging immunomodulatory strategy. A 73-year-old man with triple-positive APS and immune thrombocytopenic purpura (ITP) developed rapidly progressive leg ulcers with clinical features consistent with pyoderma gangrenosum-like disease, complicated by active MRSA and Pseudomonas aeruginosa infection and severe thrombocytopenia (12 × 109/L). Standard therapies were contraindicated: corticosteroids risked worsening infection; anticoagulation risked hemorrhage. The patient received IVIG (0.4 g/kg per dose, every 3 weeks) as primary immunomodulation, concurrent targeted antimicrobial therapy, temporary anticoagulation interruption, and discontinuation of baseline mycophenolate mofetil. Following platelet recovery above 70 × 109/L, therapeutic anticoagulation was resumed with enoxaparin (80 mg subcutaneously twice daily) and aspirin (75 mg daily). Over five months, progressive re-epithelialization culminated in complete healing with platelet recovery. This case supports the feasibility of IVIG as a bridging immunomodulatory strategy in high-risk APS cutaneous disease where standard therapies are contraindicated by concurrent infection and thrombocytopenia. The sequential management approach successfully resolved a clinically challenging scenario. This case illustrates how risk-adapted immunomodulation may enable safe management of complex APS manifestations.
2026-08-02 | Successful revision surgery after postsurgical pyoderma gangrenosum following reduction mammaplasty: A case report.
Postsurgical pyoderma gangrenosum (PSPG) is a rare neutrophilic dermatosis that occurs following surgical procedures and frequently mimics postoperative infection. Misdiagnosis may lead to repeated surgical debridement and disease progression due to pathergy. Reports describing safe reoperation following PSPG remain limited, creating uncertainty regarding subsequent reconstructive procedures. We report the case of an 18-year-old woman with well-controlled perinatal HIV who developed PSPG following bilateral reduction mammaplasty. On postoperative day (POD) 2 she developed refractory fevers and blisters near the vertical incision. By POD 6, ulceration developed on the left breast T-junction, prompting hospital admission. Dermatologic consultation and biopsy confirmed neutrophilic dermatosis consistent with pyoderma gangrenosum (PG). Multidisciplinary management involving dermatology, infectious disease, and plastic surgery led to initiation of systemic corticosteroids and immunomodulatory therapy, resulting in progressive clinical improvement and complete wound healing by eight months. After sustained disease remission and negative pathergy testing, the patient underwent staged reconstructive revision to address hypertrophic scarring and contour deformity. Revision mastopexy and autologous fat grafting were performed while the patient remained on biologic immunomodulatory therapy, with operative techniques modified to minimize cutaneous trauma. The patient healed without recurrence of PG. Postsurgical pyoderma gangrenosum presents a unique challenge for reconstructive surgeons because surgical trauma may trigger disease progression or recurrence through pathergy. This case demonstrates that revision surgery may be feasible after PG remission when disease control is sustained and perioperative management is coordinated with dermatology. Continued immunomodulatory therapy and surgical techniques that minimize cutaneous trauma may help mitigate recurrence risk and facilitate safe reconstructive revision.
2026-06-01 | P135 Advanced therapies in pyoderma gangrenosum: insights from a UK dermatology centre
Abstract Pyoderma gangrenosum (PG) is a rare, ulcerative dermatosis associated with significant pain and psychosocial distress. No advanced therapies are licensed for PG. We present a retrospective evaluation of advanced therapies in patients with PG at a UK dermatology centre. In the absence of validated severity assessment tools, clinical photographs were used to assess Pyoderma Gangrenosum Area Reduction 100 (PGAR 100; complete re-epithelialization) and PGAR 50 (≥ 50% ulcer-area reduction). Where photographs were unavailable, responses were assessed from clinical notes as effective, partial response (PR), primary failure (PF), secondary failure (SF) or early discontinuation (ED). Ten patients were identified (mean age 43.9 years, male-to-female ratio 1:1); 40% had inflammatory bowel disease. The mean duration of PG was 11 years, with a mean 4.7 prior systemic immunosuppressants. Five patients received one advanced therapy and five received two, yielding 15 episodes: adalimumab (n = 6), ustekinumab (n = 4), infliximab (n = 3) and tofacitinib (n = 2). The mean treatment duration was 23.1 months. PGAR 100 and PGAR 50 were assessable via photographs in 10 of 15 episodes; no treatment achieved PGAR 100. PGAR 50 was observed as follows: adalimumab 0 of 2, ustekinumab 2 of 3, infliximab 2 of 3 and tofacitinib 1 of 2. Review of clinical notes showed variable responses: adalimumab – 2 PR, 2 PF, 1 SF, 1 ED; ustekinumab – 2 effective, 1 PF, 1 SF; infliximab – 1 effective, 1 PR, 1 PF; tofacitinib – 1 effective, 1 PF. Overall, 80% of patients had no PG-related hospital admissions. Adverse events occurred in 40% of treatment episodes, leading to discontinuation in four cases: arthralgia (adalimumab), serious infection (tofacitinib) and rash or infusion reaction (infliximab). Limitations of this study include the small sample size, lack of validated severity measures and incomplete photographic documentation. This study provides real-world insight into advanced therapies for PG, suggesting variable effectiveness, with ustekinumab and infliximab showing the most favourable responses. Earlier biologic use may improve outcomes and reduce healthcare utilization. Prospective studies and validated severity tools are needed.
2026-05-31 | Implementation of biologic treatments for pyoderma gangrenosum through a service development framework
We present the implementation of a service development framework for biologic biosimilars in patients with refractory pyoderma gangrenosum, developed following a review of available efficacy, safety and cost data. This approach enables earlier access to effective treatment while reducing reliance on prolonged conventional immunosuppression and associated potential healthcare burden. Our model provides a pragmatic framework to improve access to biologic therapies in rare inflammatory skin disease.
2026-04-19 | Selective IL-23 Inhibition in Conventional Treatment-Refractory Pyoderma Gangrenosum: A Multicenter, Retrospective Study.
The therapeutic management of pyoderma gangrenosum (PG) is challenging. Conventional therapies, including systemic corticosteroids and cyclosporine, are limited by incomplete responses, frequent relapses, and cumulative toxicity. Emerging evidence supports a pathogenic role of the interleukin (IL)-23/IL-17 axis in PG, suggesting selective IL-23 inhibition as an appealing therapeutic approach. This study assessed the effectiveness, safety, steroid-sparing potential, and predictors of response to selective IL-23 inhibitors in conventional treatment-refractory PG. This multicenter retrospective study included adult patients with refractory PG or intolerant to conventional systemic therapies, treated with selective IL-23 inhibitors (guselkumab, risankizumab, or tildrakizumab). Clinical assessments were performed at baseline and during follow-up (1, 3, 6, 12 months, and last observation), evaluating ulcer area, number of lesions, ulcer depth, border wound bed characteristics, Investigator's Global Assessment for PG (IGAPg), and pain intensity assessed by the Numerical Rating Scale (NRS). Longitudinal changes were analyzed using non-parametric tests for repeated measures. Selective IL-23 inhibition in 18 patients was associated with a progressive reduction in total ulcer area, significant from 1 month onward (p = 0.0069; all subsequent p ≤ 0.0003). The number of active ulcers did not change at 1 month (p = 0.41) but significantly decreased from Month 3 onward (p = 0.004 to < 0.001). Ulcer depth remained unchanged at 1 month (p = 0.41) and significantly improved from Month 3 onward (p = 0.01-0.046). Border/perilesional inflammation and wound bed characteristics showed significant improvement at all follow-up visits (p = 0.0008-0.034 and p = 0.013-0.046, respectively). IGAPg score showed a significant and progressive improvement over time (all p ≤ 0.027). Pain intensity showed a significant reduction during follow-up (p = 0.004 to < 0.001). A significant steroid-sparing effect was observed, with a progressive reduction in median daily prednisone-equivalent dose during follow-up (p = 0.002-0.014). Guselkumab and risankizumab showed comparable efficacy (p = 0.182). In univariate analysis, baseline ulcer depth was the only predictor of ulcer area reduction (p = 0.039). No unexpected safety signals were observed. Selective IL-23 inhibition appears to be a well-tolerated therapeutic option for refractory PG, providing meaningful clinical improvement and a relevant steroid-sparing effect. These findings support further controlled studies to define the role of IL-23 inhibitors within PG treatment algorithms.
proteins
2026-06-10 | IL-1-targeted therapy in dermatologic conditions.
Interleukin-1 (IL-1) plays a key role in inflammasome activation, keratinocyte signaling and neutrophil recruitment, and is a driving force behind many neutrophil-rich and suppurative dermatoses. There is robust evidence supporting the use of IL-1 blockade as a disease-modifying therapy in cryopyrin-associated periodic syndromes and other monogenic periodic fever syndromes, as well as in the treatment of Schnitzler syndrome, where it can rapidly control urticarial and neutrophilic eruptions. Cohort- and series-level data demonstrate high efficacy in IL-1 receptor antagonist deficiency and steroid-refractory pyoderma gangrenosum, whereas benefits appear more heterogeneous in hidradenitis suppurativa, pustular psoriasis and proline-serine-threonine phosphatase-interacting protein 1-associated autoinflammatory diseases. In contrast, conditions such as IL-36 receptor antagonist deficiency, synovitis acne pustulosis hyperostosis osteitis syndrome, Sweet syndrome and vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic syndrome are supported only by scattered case reports or theoretical rationale, with highly variable or uncertain responses to IL-1 blockade, highlighting the importance of careful clinical and, where possible, genetic phenotyping. We summarize practical considerations for selecting agents, pediatric and adult dosing and safety. IL-1 antagonists are indispensable for a subset of IL-1-driven disorders and represent a rational rescue option for selected neutrophilic dermatoses.
2026-04-22 | The efficacy of interleukin-1 antagonists in the treatment of pyoderma gangrenosum and pyoderma gangrenosum-associated syndromes: A systematic review
Background Pyoderma gangrenosum (PG) is a rare autoinflammatory neutrophilic dermatosis with limited treatment options. It is associated with autoimmunity, inflammatory bowel disease, and autoinflammatory syndromes, including pyogenic arthritis, PG, and acne; PG, acne, and suppurative hidradenitis; and pyogenic arthritis, acne, PG, suppurative hidradenitis. Its pathogenesis centers on neutrophil dysregulation driven by interleukin 1 (IL-1) signaling, making IL-1 inhibitors (anakinra and canakinumab) promising targeted therapies, particularly for patients who have failed conventional treatments such as corticosteroids, cyclosporine, and TNF-alpha blockers. Methods A systematic review was conducted in accordance with PRISMA guidelines. PubMed (MEDLINE) was searched using the terms "pyoderma gangrenosum" AND ("anakinra" OR "canakinumab" OR "rilonacept"). A total of 36 articles were included. Treatment response was categorized as complete response, partial response, or no response, defined by explicitly reported healing outcomes. Results Among the 130 patients with PG treated with an IL-1 antagonist, the overall response rate was 72.3% (complete response 33.1%, partial response 39.2%, no response 27.7%). The cohort was 58.1% female. Anakinra accounted for 75.4% of treatments and canakinumab for 24.6%; no patients received rilonacept alone. Canakinumab demonstrated numerically higher rates of complete resolution than anakinra (46.9% vs. 28.6%), though interpretation is limited by small sample sizes and disease heterogeneity. Syndromic PG accounted for 65.4% of IL-1 antagonist-treated cases, with pyogenic arthritis, PG, and acne syndrome being the most prevalent (68.7%). Response varied by syndrome: pyogenic arthritis, PG, and acne achieved 75% complete response or partial response, while PG, acne, and suppurative hidradenitis showed no complete responses. Discussion This systematic review, representing the largest compilation of patients with PG treated with IL-1 antagonists, supports incorporating these agents into treatment algorithms, particularly for syndromic and refractory classical PG. IL-1 antagonists offer a targeted therapeutic option, especially valuable when corticosteroids or TNF-alpha inhibitors are contraindicated. Limitations include retrospective designs, heterogeneous treatment protocols, small sample sizes for syndrome-specific analyses, and a lack of standardized response criteria.
2025-10-10 | Case Report of Rare, Extensive, and Resistant Pyoderma Gangrenosum Treated Successfully With GCSF.
Pyoderma gangrenosum (PG) is a rare, noninfectious, autoimmune neutrophilic dermatosis comprising significant diagnostic and therapeutic challenges. It often presents as painful ulcerations and is frequently associated with systemic diseases such as inflammatory bowel disease and rheumatoid arthritis. Standard treatments, including corticosteroids, methotrexate, cyclosporine, and biologics like infliximab, can have variable efficacy, necessitating individualized approaches. This case report describes a 21-year-old Iranian male with extensive ulcerative plaques unresponsive to conventional treatments. The patient's history of severe anemia and familial incidence of PG suggested an underlying genetic predisposition. Remarkably, the patient showed significant improvement with granulocyte colony-stimulating factor (GCSF) therapy, which is not a standard treatment for PG. The successful use of GCSF in this case highlights its potential as an additive or alternative therapy for refractory PG, likely due to its ability to enhance neutrophil function, modulate immune responses, and promote wound healing. This case emphasizes the importance of personalized treatment strategies and the need for further research into novel therapeutic options for PG.
2025-09-15 | Advanced Wound Management in Suprapubic Pyoderma Gangrenosum Following Cesarean Section: A Strategic Therapeutic Approach
Pyoderma gangrenosum (PG) is a rare, painful skin condition characterized by rapidly progressing necrotic ulcers. Due to its complexity, it requires advanced wound management involving thorough assessment, multidisciplinary care, and appropriate use of wound care technology. This case report presents a patient who developed suprapubic PG as a postoperative complication following cesarean delivery. Specialized treatment was administered at the Wound Care Clinic (CH), including the application of antiseptic and bioactive topical agents, a range of advanced dressings -such as nonadherent films, antimicrobial-coated materials, silver-based hydrogels, and collagen matrices-, and the use of adjunctive therapies like magnetotherapy. A structured wound care strategy was implemented, emphasizing decontamination, protection, and the facilitation of tissue regeneration. The intervention resulted in complete reepithelialization and progressive surgical wound closure without further complications. This case underscores the value of advanced wound care protocols in managing complex presentations of PG and highlights the importance of tailored, multidisciplinary approaches in achieving favorable clinical outcomes.
2025-06-27 | P024 Anakinra for recalcitrant pyoderma gangrenosum with Achilles tendon exposure
Abstract Pyoderma gangrenosum (PG) is an ulcerative autoinflammatory neutrophilic dermatosis associated with systemic disorders. It often has a chronic relapsing course characterized by rapidly enlarging painful ulcers, which may be challenging to manage. A 61-year-old man with a history of non-insulin-dependent diabetes, hypertension, chronic kidney disease, atrial fibrillation and heart failure, presented initially to the vascular team with bilateral nonhealing painful ulcers that developed following an episode of cellulitis. Initial punch biopsy showed neutrophilic infiltrate in keeping with PG, which prompted dermatology referral. Repeat incisional biopsy by dermatology from the ulcer edge showed venous stasis, granulation tissue with neutrophilic infiltrate and no evidence vasculitis or a thrombus. Investigations for underlying malignancy and inflammatory bowel disease were negative. Unfortunately, there was rapid progression of his lower-limb ulceration with exposure of the left Achilles tendon. He was commenced on ciclosporin with initial improvement, but uptitration was limited to 3 mg kg−1 per day due to the development of significant renal impairment, which required medical admission. Treatment was switched to adalimumab fortnightly. His ulcers progressed aggressively despite an increased dose up to 80 mg weekly. The ulcers were also unresponsive to oral steroids (1 mg kg−1 per day), which were poorly tolerated in the context of his comorbidities. He was commenced on anakinra (100 mg daily), a recombinant interleukin-1 inhibitor, and initial monthly monitoring of neutrophils was carried out. Combined with ongoing lower-limb wound care and high-grade compression, anakinra has resulted in significant ulcer improvement and gradual healing, and has been well tolerated. After 14 months of treatment, all areas of ulceration are almost completely healed with one area of mild overgranulation, currently being treated with topical clobetasol propionate. This case highlights the difficulties in treating PG, as side-effects of medications must be balanced with systemic comorbidities. It also reveals the importance of regular wound care and lower-limb compression in the setting of ulcers at this site. Anakinra represents a potentially effective treatment option with a relatively low side-effect profile.
other
2024-01-30 | What can inherited immunodeficiencies reveal about pyoderma gangrenosum?
Pyoderma gangrenosum (PG) is a rare ulcerative neutrophilic dermatosis that is occasionally associated with primary immunodeficiency. Though contributions from dysregulation of the innate immune system, neutrophil dysfunction and genetic predisposition have been postulated, the precise pathogenesis of PG has not yet been elucidated. This article reviews reported cases of coexisting PG and primary immunodeficiency in order to gain insight into the complex pathophysiology of PG. Our findings suggest that variations in genes such as RAG1, ITGB2, IRF2BP2 and NFκB1 might play a role in genetically predisposing patients to develop PG. These studies support the feasibility of the role of somatic gene variation in the pathogenesis of PG which warrants further exploration to guide targeted therapeutics.
2016-05-09 | Gene Therapy for Pyoderma Gangrenosum: Optimal Transfection Conditions and Effect of Drugs on Gene Delivery in the HaCaT Cell Line Using Cationic Liposomes
Pyoderma gangrenosum (PG) is a rare ulcerative skin disease, currently treated empirically with immunosuppression. PG is a good target for gene therapy since the skin is easily accessible. This study used the FDA-approved vector Lipofectamine® 2000 to investigate in vitro transfection of skin keratinocytes. The aim was to determine an optimum transfection protocol, including the effect of drugs currently used to treat PG on the efficiency of gene transfer, since gene therapy is unlikely to be used as monotherapy.Cells of the HaCaT line were transfected with the lacZ reporter gene, and transgene expression was measured after a given time period. Conditions tested were: relative concentrations of DNA and Lipofectamine®, time from transfection to measurement of expression, pH, and exposure to clinically relevant drugs (hydrocortisone, methotrexate, infliximab).The greatest levels of β-galactosidase expression were observed using a DNA:Lipofectamine® ratio of 1:5 (μg/μl) on day 3 after transfection, using culture medium at pH 7, and in the presence of hydrocortisone. Transfection efficiency was reduced by the presence of methotrexate and not significantly affected by infliximab.Gene therapy is a potential future strategy for the management of PG; this study is a step towards the development of a topical gene-based agent.
2000-04-01 | Interleukin-8 Overexpression Is Present in Pyoderma Gangrenosum Ulcers and Leads to Ulcer Formation in Human Skin Xenografts
Interleukin-8 (IL-8) is a potent chemotactic polypeptide for neutrophils. However, the role of this cytokine during inflammation remains unclear. Skin specimens from patients with pyoderma gangrenosum demonstrated IL-8 overexpression in skin ulcers, which suggests a role for IL-8 in the development of the disease. We therefore constructed a recombinant adenovirus expressing the complementary deoxyribonucleic acid encoding human IL-8 (IL-8/Ad5) that induces a 2000-fold increase in IL-8 expression of infected human fibroblasts in vitro. Human skin engrafted to severe combined immunodeficiency mice and then injected with the recombinant virus demonstrated erythema, an intense perivascular infiltration of neutrophils, and extravasation of erythrocytes after 8 hours. By 12 hours after injection, neutrophils had accumulated beneath the epidermis, which then necrotized, and one or more ulcers that remained for approximately 2 weeks were observed. Clinically and histologically, the ulcers resembled pyoderma gangrenosum. These clinical and experimental findings suggest an etiologic role of IL-8 in the pathogenesis of pyoderma gangrenosum.
small molecules
2026-08-16 | NLRP3 inflammasome activation is associated with type 1 inflammation and neutrophil activation in pyoderma gangrenosum across human and murine models.
Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by painful, nonhealing cutaneous ulcers. Although dysregulated innate immunity and neutrophil activation are implicated in its pathogenesis, the underlying molecular mechanisms remain poorly defined. This study aimed to identify conserved pathogenic mechanisms by integrating analyses of human PG lesions and a brequinar-induced PG-like murine model and to assess therapeutic relevance. Skin biopsy specimens from patients with PG and publicly available RNA-sequencing data were analyzed alongside the murine model using histological and transcriptomic approaches. Cross-species transcriptomic integration identified shared inflammatory pathways between human and murine PG. Human PG lesions showed increased neutrophil infiltration, neutrophil extracellular trap formation, and a dominant type 1 inflammatory profile, all of which were recapitulated in the brequinar-induced mouse model, together with impaired wound healing. Transcriptomic analyses revealed enhanced oxidative stress responses and activation of the NLRP3/caspase-1 inflammasome pathway as a conserved pathogenic axis. In the murine model, both prednisolone and avacopan suppressed inflammatory cytokine expression and neutrophil activation; however, only avacopan significantly improved wound healing. Collectively, these findings suggest that NLRP3 inflammasome activation is associated with type 1 inflammation and neutrophil extracellular trap formation and may represent a PG-associated inflammatory pathway.
2026-08-15 | Preliminary exploration of effects of the JAK inhibitor tofacitinib on pyoderma gangrenosum: In vitro inhibition of NETs and Th17 differentiation.
Pyoderma gangrenosum (PG), a refractory inflammatory disorder, remains a condition with incompletely understood pathogenesis. Currently, no FDA-approved treatments are available. Janus kinase (JAK) inhibitors have been reported sporadically in case studies as effective treatments for PG. To characterize the cellular and molecular landscape associated with JAK/STAT (signal transducer and activator of transcription) pathway overactivation in PG lesions, and investigate the potential effects of tofacitinib on PG. Single-cell RNA sequencing (scRNA-seq) and multiplex immunohistochemistry (mIHC) were employed to characterize the cellular and molecular landscape of JAK/STAT pathway overactivation in PG. In vitro experiments (immunostaining, qPCR, western blot, flow cytometry) were performed to further validate the potential effects of tofacitinib on PG. We identified significant overactivation of the JAK/STAT pathway in PG lesions-particularly in advanced stages-which, in terms of immune inflammation, is primarily driven by myeloid cells and T cells. This activation was associated with enhanced neutrophil extracellular trap (NET) formation in myeloid cells and aberrant differentiation/plasticity of Th17 and Th17.1 (IL-17/IFN-γ double-producing) cells. In vitro cell experiments further demonstrated that the JAK inhibitor tofacitinib suppresses STAT phosphorylation in myeloid and T cells, myeloid NETosis, and IL-17A production. Our study investigated immunological profiling of PG lesions via scRNA-seq and mIHC, along with in vitro validation. These findings delineate a multi-axis cellular and molecular landscape of PG linked to aberrant JAK/STAT signaling, and provide preliminary in vitro evidence supporting potential inhibitory effects of tofacitinib on key pathological processes of PG.
2026-08-03 | Dual-Site Postsurgical Pyoderma Gangrenosum of the Breast and Back With Delayed Diagnosis: A Case Report
Objective: Unusual clinical course Background:Postsurgical pyoderma gangrenosum is a rare neutrophilic dermatosis that can mimic infection, wound dehiscence, malignancy, foreign-body reaction, or impaired surgical healing.Diagnostic delay is common and may lead to repeated debridement, which can worsen ulceration through pathergy.This case highlights the diagnostic challenge of multifocal postsurgical pyoderma gangrenosum involving anatomically distinct sites after procedures initially performed for presumed benign lesions. Case Report:A 70-year-old woman with celiac disease and prior left breast cancer treated with lumpectomy, chemotherapy, radiation, and implant reconstruction developed nonhealing ulcers of the left superior breast and left lower back after surgical treatment of benign lesions.Initial evaluation favored retained cyst lining, foreign-body reaction, infection, impaired wound healing, and possible implant-related complications.Despite advanced wound therapies, antimicrobials, and biologic wound products, both lesions progressively enlarged.Biopsies demonstrated abscess formation, multinucleated giant cells, and sinus tract formation without malignancy.Wound cultures and pulmonary findings complicated the diagnostic course, but neither targeted antimicrobial nor prolonged antifungal therapy produced sustained improvement.The diagnosis was clinically supported by worsening after procedural intervention, exclusion of malignancy and persistent infection, multifocal involvement, and rapid response after initiation of topical and intralesional corticosteroid therapy. Conclusions:This case supports considering postsurgical pyoderma gangrenosum in refractory postsurgical wounds that worsen despite local wound-directed interventions, particularly when lesions involve multiple anatomically distinct surgical sites.The complete resolution of both lesions after topical and intralesional corticosteroid therapy further supports the importance of recognizing an inflammatory, pathergy-driven process once infection, malignancy, and other local causes have been reasonably excluded.Earlier recognition may help avoid repeated procedural trauma, unnecessary treatment escalation, and prolonged morbidity.
2026-08-03 | Postoperative Pyoderma Gangrenosum Following Varicose Vein Surgery: Recognizing a Rare Surgical Mimic Before Extensive Tissue Loss.
Postoperative pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis that frequently masquerades as a surgical site infection. Because its clinical presentation closely resembles postoperative cellulitis or even necrotizing soft tissue infection, diagnosis is often delayed. Misdiagnosis may result in unnecessary antibiotic escalation, repeated surgical interventions, and progressive tissue destruction due to pathergy. This case highlights the importance of early recognition of PG and serves as a reminder for surgeons to consider this uncommon diagnosis when postoperative wounds fail to respond to conventional treatment. A 75-year-old woman underwent elective open varicose vein surgery (ligation of neocrosse veins and phlebectomies) for recurrent symptomatic varicose veins of the left lower limb. One week postoperatively, she developed a painful erythematous wound that was initially diagnosed as a surgical site infection. Despite drainage, repeated wound care, and escalation from oral to broad-spectrum intravenous antibiotic therapy, the lesion rapidly progressed into an extensive necrotic ulcer. Repeated wound cultures and blood cultures remained sterile, while computed tomography scans demonstrated inflammatory changes without evidence of a drainable collection or necrotizing soft tissue infection. Following dermatological consultation, postoperative PG was suspected and confirmed by skin biopsy. High-dose systemic corticosteroid therapy was initiated, resulting in rapid clinical improvement, cessation of ulcer progression, and subsequent wound healing. This case illustrates the diagnostic challenge of postoperative PG and emphasizes several clinical features that should prompt reconsideration of a presumed surgical site infection, including disproportionate pain, rapidly progressive ulceration, sterile cultures, failure of appropriate antimicrobial therapy, and inconclusive imaging findings. Early recognition is essential, as surgical manipulation may exacerbate disease progression through pathergy. Postoperative PG should be considered in any patient presenting with a rapidly progressive postoperative wound that fails to improve despite appropriate antimicrobial treatment. Increased awareness among surgeons may facilitate earlier diagnosis, prevent unnecessary surgical procedures, and reduce the risk of extensive tissue loss.
2026-07-24 | Recurrence after healing in pyoderma gangrenosum: a prospective registry-based cohort study.
Pyoderma gangrenosum is a rare neutrophilic dermatosis with potential for relapse after healing, yet recurrence in real-world settings remains unknown. We aimed to evaluate recurrence patterns to inform clinical practice and future research. Data were abstracted from a uniquely, prospectively maintained pyoderma gangrenosum registry. A cohort of patients with pyoderma gangrenosum seen between December 1st, 2019 and March 1st, 2026 who healed within this timeframe was identified. Two subgroups were then created: those who remained healed, and those who had a recurrence. Descriptive statistics summarised recurrence characteristics; Kaplan-Meier methods estimated a cumulative incidence of recurrence, and Cox proportional hazards modelling identified predictors of recurrence. Of 116 patients with healed pyoderma gangrenosum, 41 (35%) experienced a recurrence, generating a recurrence proportion of 35·3% (95% CI 26·7-44·8). Nominal associations with recurrence on univariable analysis included history of diabetes mellitus (hazard ratio 2·1, 95% CI 1·1-4·0, p = 0·024) and ever-smoking (1·8, 1·0-3·4, p = 0·057). Baseline characteristics differing between recurrence and non-recurrence groups included age (p = 0·033), history of diabetes (p = 0·0060), and ulcer age at presentation (p = 0·046). Cumulative recurrence risk was calculated as 27% (95% CI 18·1-35·0) at 1 year and 41·3% (95% CI 30·4-50·5) at 5 years. Pyoderma gangrenosum recurred in approximately a third of patients. A history of diabetes showed a borderline association with recurrence, while the univariable signal for smoking was attenuated after adjustment. Recurrence risk remains elevated five years after initial healing, and peristomal pyoderma gangrenosum is associated with higher recurrence rates, suggesting that maintenance therapy may be necessary for certain patient populations after achieving ulcer closure. Our data highlight the need for prospective evaluation of maintenance approaches. Future work will focus on individual recurrence predictors. This is an unfunded study.
cell therapies
2026-04-14 | Multidisciplinary Approach to Complex Lower Extremity Limb Salvage in Pyogenic Arthritis, Pyoderma Gangrenosum, and Acne (PAPA) Syndrome: A Case Report.
Limb salvage using free tissue transfer in patients with rare autoinflammatory syndromes is poorly described, and the safety of microvascular reconstruction in this population remains uncertain. Hereditary pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome is characterized by dysregulated inflammation, pathergy, and impaired wound healing, raising concern for flap compromise and postoperative complications. We report a rare case of lower extremity free tissue transfer in a patient with PAPA syndrome. A 66-year-old woman with rheumatoid arthritis and PAPA syndrome presented with rapid wound breakdown, violaceous ulceration, exposed hardware, and periprosthetic joint infection following left total knee arthroplasty (TKA). Examination revealed an approximately 9 × 7 cm anterior knee defect with subtotal patellar tendon necrosis. After multidisciplinary optimization, she underwent single-stage irrigation and debridement, hardware removal, revision TKA with patellar tendon reconstruction using gracilis autograft, and immediate coverage with a 22 × 14 cm free latissimus dorsi (LD) muscle flap. The flap was anastomosed end-to-side to the anterior tibial artery with venous outflow via the venae comitantes and loosely inset to preserve future surgical access. The donor site was closed primarily. A 21 × 13 cm staged split-thickness skin graft was performed 1 week later, with adjunctive postoperative hyperbaric oxygen therapy (HBOT). Initial healing was uncomplicated, with complete graft take and donor-site healing. Four months postoperatively, the patient developed chronic sinus tracts and recurrent periprosthetic infection requiring flap re-elevation, debridement, and hardware exchange; the flap pedicle was preserved, and coverage maintained. At one-year follow-up, all wounds had healed; flap coverage was durable with acceptable cosmesis, and the patient was ambulatory for short distances without assistance. She was last seen infection-free and full-weightbearing 4 months later. This case demonstrates that microvascular limb salvage is feasible in PAPA syndrome when guided by multidisciplinary planning and strategic flap design.
2026-03-11 | The Use of Human Placental Allografts for Pyoderma Gangrenosum
Background/Objectives: Pyoderma gangrenosum (PG) is a rapidly progressive, ulcerating condition that can cause large, painful lesions when uncontrolled. There is currently no standard of care treatment for severe PG ulcers refractory to systemic treatment. The present study aims to characterize the outcomes of placental allografts in treating severe PG lesions. Methods: A single institution retrospective chart review was conducted at the University of South Florida affiliated sites examining PG patients that received placental allograft treatment. Results: The review returned five patients with clinically diagnosed or biopsy-proven PG treated with placental allograft. In all five patients, application of placental allograft resulted in varying degrees of short-term (<1 month) improvement. Near-complete resolution was observed in one patient. Out of the 20 total allografts placed between the 5 patients, only one had an adverse event of infection within one week of placement. Grafts were otherwise very well tolerated by all patients. Conclusions: Placental allografts show promising adjunctive therapeutic potential for severe PG lesions with preliminary findings showing good viability and safety profiles. Future prospective controlled studies should be performed to further examine the viability of this adjunctive treatment in this disease.
2025-08-06 | Larval Debridement Therapy for Management of Postsurgical Wounds in the Setting of Pyoderma Gangrenosum.
Pyoderma gangrenosum (PG) is a rare disease affecting 5.8 adults per 100,000 in the United States. PG is not exclusively seen in inflammatory bowel disease; however, among those with inflammatory bowel disease, upward of 0.4%-2% may have concomitant PG. Wounds in the setting of PG are a challenge for clinicians to treat, especially when refractory to first-line agents such as immunosuppressive agents and biologic therapy. Herein, we present the case of a patient with PG who underwent a colostomy reversal, developed a PG wound, and was successfully treated with larval debridement therapy (LDT). A 62-year-old man underwent elective reversal of his loop sigmoid colostomy. He had developed an anastomotic leak, requiring a descending colostomy and mesh removal. Ultimately, he developed a pyoderma wound at the previous ostomy site. Cyclosporine, prednisone, antibiotics, dressing changes, a single debridement, and biologic therapy failed to heal the wound. After 2 applications of LDT, the wound healed completely. Literature regarding LDT for nonhealing diabetic wounds and pressure ulcers is well described; however, its use for abdominal wounds in the setting of PG is not well documented. Most case reports on LDT for abdominal wounds discuss only a partial response with minimal to no wound healing. Unlike the previously published literature, our case report demonstrated complete wound response without decreased larvae survivability in the setting of previously administered immunosuppressants. LDT appears to be a viable option for patients who do not appropriately respond to first-line medical therapies for surgical wounds in the setting of PG.
2025-06-09 | PYODERMA GANGRENOSUM WITH NON-PSEUDOMONAL ECTHYMA GANGRENOSUM IN MYELODYSPLASTIC SYNDROME TREATED WITH ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION.
Co-occurrence of pyoderma gangrenosum (PG) and ecthyma gangrenosum (EG) pose diagnostic and therapeutic challenges in immunocompromised patients. A 47-year-old Filipino woman with transfusion-dependent intermediate-risk myelodysplastic syndrome (MDS) was admitted to our institution for allogeneic hematopoietic stem cell transplantation (HSCT). During the preparation for allogeneic HSCT, she developed several erythematous ulcerated lesions on the lower extremities, which were initially managed as PG. Subsequent febrile episodes and worsening lesions with isolated Escherichia coli in blood and tissue cultures lead to the diagnosis of EG complicating PG. She was treated through targeted antibiotics, wound debridement, and proper wound care. After the resolution of the infection and upon starting low-dose immunosuppression followed by allogeneic HSCT, her left leg lesions showed progressive improvement. Six months after HSCT, lesions were completely resolved with complete epithelialization. This case highlights the importance of accurate diagnosis and integrated management of complex conditions like PG and EG in immunocompromised patients. The successful resolution of lesions post-HSCT underscores the potential curative role of stem cell transplantation in managing MDS-associated PG.
2024-12-27 | The Striking Power of Amniotic Fluid and Its Exosomes Collected at the End of a Normal Pregnancy on Severe Inflammation and Tissue Repair.
With this short communication, which contains a new case report on diabetic ulcer, we summarize our research progress in treating several complex conditions at a point where currently available treatments were failing to help the affected patients. We review the first case of lower back pain due to severe spondylitis (T12-L1) treated with intravenous injections of a sterile fraction of human purified amniotic fluid (ViX001) obtained from thoroughly screened volunteers at the time of planned c-section at the term of normal pregnancies. Then, we review the first case of recalcitrant diabetic ulcer treated successfully by twice-daily applications of ViX001 directly on the wound and describe another case of diabetic ulcer treated successfully with ViX001. Next, we review the treatment of severe burns with direct application of ViX001 on the burns leading to accelerated improvement of the burn lesions. Finally, we review the first treatment of a patient with advanced pyoderma gangrenosum with ViX001, with significant reduction of pain, inflammation, and observation of tissue regeneration. We conclude our review with speculations on the mechanism of action of ViX001, the importance of extracellular vesicles in the amniotic fluid for its biological activity, and the need for expanding our studies to generate a better understanding of the omics signature of this incredibly beneficial material.
antibodies
2026-08-12 | Case Report: IVIG as a bridging strategy in high-risk antiphospholipid syndrome with infected cutaneous ulceration and thrombocytopenia.
Severe cutaneous ulceration in antiphospholipid syndrome (APS) with concurrent infection and thrombocytopenia presents a therapeutic dilemma: standard immunosuppression risks worsening infection, while anticoagulation risks hemorrhage. We present a high-risk case successfully managed using intravenous immunoglobulin (IVIG) as a bridging immunomodulatory strategy. A 73-year-old man with triple-positive APS and immune thrombocytopenic purpura (ITP) developed rapidly progressive leg ulcers with clinical features consistent with pyoderma gangrenosum-like disease, complicated by active MRSA and Pseudomonas aeruginosa infection and severe thrombocytopenia (12 × 109/L). Standard therapies were contraindicated: corticosteroids risked worsening infection; anticoagulation risked hemorrhage. The patient received IVIG (0.4 g/kg per dose, every 3 weeks) as primary immunomodulation, concurrent targeted antimicrobial therapy, temporary anticoagulation interruption, and discontinuation of baseline mycophenolate mofetil. Following platelet recovery above 70 × 109/L, therapeutic anticoagulation was resumed with enoxaparin (80 mg subcutaneously twice daily) and aspirin (75 mg daily). Over five months, progressive re-epithelialization culminated in complete healing with platelet recovery. This case supports the feasibility of IVIG as a bridging immunomodulatory strategy in high-risk APS cutaneous disease where standard therapies are contraindicated by concurrent infection and thrombocytopenia. The sequential management approach successfully resolved a clinically challenging scenario. This case illustrates how risk-adapted immunomodulation may enable safe management of complex APS manifestations.
2026-08-02 | Successful revision surgery after postsurgical pyoderma gangrenosum following reduction mammaplasty: A case report.
Postsurgical pyoderma gangrenosum (PSPG) is a rare neutrophilic dermatosis that occurs following surgical procedures and frequently mimics postoperative infection. Misdiagnosis may lead to repeated surgical debridement and disease progression due to pathergy. Reports describing safe reoperation following PSPG remain limited, creating uncertainty regarding subsequent reconstructive procedures. We report the case of an 18-year-old woman with well-controlled perinatal HIV who developed PSPG following bilateral reduction mammaplasty. On postoperative day (POD) 2 she developed refractory fevers and blisters near the vertical incision. By POD 6, ulceration developed on the left breast T-junction, prompting hospital admission. Dermatologic consultation and biopsy confirmed neutrophilic dermatosis consistent with pyoderma gangrenosum (PG). Multidisciplinary management involving dermatology, infectious disease, and plastic surgery led to initiation of systemic corticosteroids and immunomodulatory therapy, resulting in progressive clinical improvement and complete wound healing by eight months. After sustained disease remission and negative pathergy testing, the patient underwent staged reconstructive revision to address hypertrophic scarring and contour deformity. Revision mastopexy and autologous fat grafting were performed while the patient remained on biologic immunomodulatory therapy, with operative techniques modified to minimize cutaneous trauma. The patient healed without recurrence of PG. Postsurgical pyoderma gangrenosum presents a unique challenge for reconstructive surgeons because surgical trauma may trigger disease progression or recurrence through pathergy. This case demonstrates that revision surgery may be feasible after PG remission when disease control is sustained and perioperative management is coordinated with dermatology. Continued immunomodulatory therapy and surgical techniques that minimize cutaneous trauma may help mitigate recurrence risk and facilitate safe reconstructive revision.
2026-06-01 | P135 Advanced therapies in pyoderma gangrenosum: insights from a UK dermatology centre
Abstract Pyoderma gangrenosum (PG) is a rare, ulcerative dermatosis associated with significant pain and psychosocial distress. No advanced therapies are licensed for PG. We present a retrospective evaluation of advanced therapies in patients with PG at a UK dermatology centre. In the absence of validated severity assessment tools, clinical photographs were used to assess Pyoderma Gangrenosum Area Reduction 100 (PGAR 100; complete re-epithelialization) and PGAR 50 (≥ 50% ulcer-area reduction). Where photographs were unavailable, responses were assessed from clinical notes as effective, partial response (PR), primary failure (PF), secondary failure (SF) or early discontinuation (ED). Ten patients were identified (mean age 43.9 years, male-to-female ratio 1:1); 40% had inflammatory bowel disease. The mean duration of PG was 11 years, with a mean 4.7 prior systemic immunosuppressants. Five patients received one advanced therapy and five received two, yielding 15 episodes: adalimumab (n = 6), ustekinumab (n = 4), infliximab (n = 3) and tofacitinib (n = 2). The mean treatment duration was 23.1 months. PGAR 100 and PGAR 50 were assessable via photographs in 10 of 15 episodes; no treatment achieved PGAR 100. PGAR 50 was observed as follows: adalimumab 0 of 2, ustekinumab 2 of 3, infliximab 2 of 3 and tofacitinib 1 of 2. Review of clinical notes showed variable responses: adalimumab – 2 PR, 2 PF, 1 SF, 1 ED; ustekinumab – 2 effective, 1 PF, 1 SF; infliximab – 1 effective, 1 PR, 1 PF; tofacitinib – 1 effective, 1 PF. Overall, 80% of patients had no PG-related hospital admissions. Adverse events occurred in 40% of treatment episodes, leading to discontinuation in four cases: arthralgia (adalimumab), serious infection (tofacitinib) and rash or infusion reaction (infliximab). Limitations of this study include the small sample size, lack of validated severity measures and incomplete photographic documentation. This study provides real-world insight into advanced therapies for PG, suggesting variable effectiveness, with ustekinumab and infliximab showing the most favourable responses. Earlier biologic use may improve outcomes and reduce healthcare utilization. Prospective studies and validated severity tools are needed.
2026-05-31 | Implementation of biologic treatments for pyoderma gangrenosum through a service development framework
We present the implementation of a service development framework for biologic biosimilars in patients with refractory pyoderma gangrenosum, developed following a review of available efficacy, safety and cost data. This approach enables earlier access to effective treatment while reducing reliance on prolonged conventional immunosuppression and associated potential healthcare burden. Our model provides a pragmatic framework to improve access to biologic therapies in rare inflammatory skin disease.
2026-04-19 | Selective IL-23 Inhibition in Conventional Treatment-Refractory Pyoderma Gangrenosum: A Multicenter, Retrospective Study.
The therapeutic management of pyoderma gangrenosum (PG) is challenging. Conventional therapies, including systemic corticosteroids and cyclosporine, are limited by incomplete responses, frequent relapses, and cumulative toxicity. Emerging evidence supports a pathogenic role of the interleukin (IL)-23/IL-17 axis in PG, suggesting selective IL-23 inhibition as an appealing therapeutic approach. This study assessed the effectiveness, safety, steroid-sparing potential, and predictors of response to selective IL-23 inhibitors in conventional treatment-refractory PG. This multicenter retrospective study included adult patients with refractory PG or intolerant to conventional systemic therapies, treated with selective IL-23 inhibitors (guselkumab, risankizumab, or tildrakizumab). Clinical assessments were performed at baseline and during follow-up (1, 3, 6, 12 months, and last observation), evaluating ulcer area, number of lesions, ulcer depth, border wound bed characteristics, Investigator's Global Assessment for PG (IGAPg), and pain intensity assessed by the Numerical Rating Scale (NRS). Longitudinal changes were analyzed using non-parametric tests for repeated measures. Selective IL-23 inhibition in 18 patients was associated with a progressive reduction in total ulcer area, significant from 1 month onward (p = 0.0069; all subsequent p ≤ 0.0003). The number of active ulcers did not change at 1 month (p = 0.41) but significantly decreased from Month 3 onward (p = 0.004 to < 0.001). Ulcer depth remained unchanged at 1 month (p = 0.41) and significantly improved from Month 3 onward (p = 0.01-0.046). Border/perilesional inflammation and wound bed characteristics showed significant improvement at all follow-up visits (p = 0.0008-0.034 and p = 0.013-0.046, respectively). IGAPg score showed a significant and progressive improvement over time (all p ≤ 0.027). Pain intensity showed a significant reduction during follow-up (p = 0.004 to < 0.001). A significant steroid-sparing effect was observed, with a progressive reduction in median daily prednisone-equivalent dose during follow-up (p = 0.002-0.014). Guselkumab and risankizumab showed comparable efficacy (p = 0.182). In univariate analysis, baseline ulcer depth was the only predictor of ulcer area reduction (p = 0.039). No unexpected safety signals were observed. Selective IL-23 inhibition appears to be a well-tolerated therapeutic option for refractory PG, providing meaningful clinical improvement and a relevant steroid-sparing effect. These findings support further controlled studies to define the role of IL-23 inhibitors within PG treatment algorithms.
proteins
2026-06-10 | IL-1-targeted therapy in dermatologic conditions.
Interleukin-1 (IL-1) plays a key role in inflammasome activation, keratinocyte signaling and neutrophil recruitment, and is a driving force behind many neutrophil-rich and suppurative dermatoses. There is robust evidence supporting the use of IL-1 blockade as a disease-modifying therapy in cryopyrin-associated periodic syndromes and other monogenic periodic fever syndromes, as well as in the treatment of Schnitzler syndrome, where it can rapidly control urticarial and neutrophilic eruptions. Cohort- and series-level data demonstrate high efficacy in IL-1 receptor antagonist deficiency and steroid-refractory pyoderma gangrenosum, whereas benefits appear more heterogeneous in hidradenitis suppurativa, pustular psoriasis and proline-serine-threonine phosphatase-interacting protein 1-associated autoinflammatory diseases. In contrast, conditions such as IL-36 receptor antagonist deficiency, synovitis acne pustulosis hyperostosis osteitis syndrome, Sweet syndrome and vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic syndrome are supported only by scattered case reports or theoretical rationale, with highly variable or uncertain responses to IL-1 blockade, highlighting the importance of careful clinical and, where possible, genetic phenotyping. We summarize practical considerations for selecting agents, pediatric and adult dosing and safety. IL-1 antagonists are indispensable for a subset of IL-1-driven disorders and represent a rational rescue option for selected neutrophilic dermatoses.
2026-04-22 | The efficacy of interleukin-1 antagonists in the treatment of pyoderma gangrenosum and pyoderma gangrenosum-associated syndromes: A systematic review
Background Pyoderma gangrenosum (PG) is a rare autoinflammatory neutrophilic dermatosis with limited treatment options. It is associated with autoimmunity, inflammatory bowel disease, and autoinflammatory syndromes, including pyogenic arthritis, PG, and acne; PG, acne, and suppurative hidradenitis; and pyogenic arthritis, acne, PG, suppurative hidradenitis. Its pathogenesis centers on neutrophil dysregulation driven by interleukin 1 (IL-1) signaling, making IL-1 inhibitors (anakinra and canakinumab) promising targeted therapies, particularly for patients who have failed conventional treatments such as corticosteroids, cyclosporine, and TNF-alpha blockers. Methods A systematic review was conducted in accordance with PRISMA guidelines. PubMed (MEDLINE) was searched using the terms "pyoderma gangrenosum" AND ("anakinra" OR "canakinumab" OR "rilonacept"). A total of 36 articles were included. Treatment response was categorized as complete response, partial response, or no response, defined by explicitly reported healing outcomes. Results Among the 130 patients with PG treated with an IL-1 antagonist, the overall response rate was 72.3% (complete response 33.1%, partial response 39.2%, no response 27.7%). The cohort was 58.1% female. Anakinra accounted for 75.4% of treatments and canakinumab for 24.6%; no patients received rilonacept alone. Canakinumab demonstrated numerically higher rates of complete resolution than anakinra (46.9% vs. 28.6%), though interpretation is limited by small sample sizes and disease heterogeneity. Syndromic PG accounted for 65.4% of IL-1 antagonist-treated cases, with pyogenic arthritis, PG, and acne syndrome being the most prevalent (68.7%). Response varied by syndrome: pyogenic arthritis, PG, and acne achieved 75% complete response or partial response, while PG, acne, and suppurative hidradenitis showed no complete responses. Discussion This systematic review, representing the largest compilation of patients with PG treated with IL-1 antagonists, supports incorporating these agents into treatment algorithms, particularly for syndromic and refractory classical PG. IL-1 antagonists offer a targeted therapeutic option, especially valuable when corticosteroids or TNF-alpha inhibitors are contraindicated. Limitations include retrospective designs, heterogeneous treatment protocols, small sample sizes for syndrome-specific analyses, and a lack of standardized response criteria.
2025-10-10 | Case Report of Rare, Extensive, and Resistant Pyoderma Gangrenosum Treated Successfully With GCSF.
Pyoderma gangrenosum (PG) is a rare, noninfectious, autoimmune neutrophilic dermatosis comprising significant diagnostic and therapeutic challenges. It often presents as painful ulcerations and is frequently associated with systemic diseases such as inflammatory bowel disease and rheumatoid arthritis. Standard treatments, including corticosteroids, methotrexate, cyclosporine, and biologics like infliximab, can have variable efficacy, necessitating individualized approaches. This case report describes a 21-year-old Iranian male with extensive ulcerative plaques unresponsive to conventional treatments. The patient's history of severe anemia and familial incidence of PG suggested an underlying genetic predisposition. Remarkably, the patient showed significant improvement with granulocyte colony-stimulating factor (GCSF) therapy, which is not a standard treatment for PG. The successful use of GCSF in this case highlights its potential as an additive or alternative therapy for refractory PG, likely due to its ability to enhance neutrophil function, modulate immune responses, and promote wound healing. This case emphasizes the importance of personalized treatment strategies and the need for further research into novel therapeutic options for PG.
2025-09-15 | Advanced Wound Management in Suprapubic Pyoderma Gangrenosum Following Cesarean Section: A Strategic Therapeutic Approach
Pyoderma gangrenosum (PG) is a rare, painful skin condition characterized by rapidly progressing necrotic ulcers. Due to its complexity, it requires advanced wound management involving thorough assessment, multidisciplinary care, and appropriate use of wound care technology. This case report presents a patient who developed suprapubic PG as a postoperative complication following cesarean delivery. Specialized treatment was administered at the Wound Care Clinic (CH), including the application of antiseptic and bioactive topical agents, a range of advanced dressings -such as nonadherent films, antimicrobial-coated materials, silver-based hydrogels, and collagen matrices-, and the use of adjunctive therapies like magnetotherapy. A structured wound care strategy was implemented, emphasizing decontamination, protection, and the facilitation of tissue regeneration. The intervention resulted in complete reepithelialization and progressive surgical wound closure without further complications. This case underscores the value of advanced wound care protocols in managing complex presentations of PG and highlights the importance of tailored, multidisciplinary approaches in achieving favorable clinical outcomes.
2025-06-27 | P024 Anakinra for recalcitrant pyoderma gangrenosum with Achilles tendon exposure
Abstract Pyoderma gangrenosum (PG) is an ulcerative autoinflammatory neutrophilic dermatosis associated with systemic disorders. It often has a chronic relapsing course characterized by rapidly enlarging painful ulcers, which may be challenging to manage. A 61-year-old man with a history of non-insulin-dependent diabetes, hypertension, chronic kidney disease, atrial fibrillation and heart failure, presented initially to the vascular team with bilateral nonhealing painful ulcers that developed following an episode of cellulitis. Initial punch biopsy showed neutrophilic infiltrate in keeping with PG, which prompted dermatology referral. Repeat incisional biopsy by dermatology from the ulcer edge showed venous stasis, granulation tissue with neutrophilic infiltrate and no evidence vasculitis or a thrombus. Investigations for underlying malignancy and inflammatory bowel disease were negative. Unfortunately, there was rapid progression of his lower-limb ulceration with exposure of the left Achilles tendon. He was commenced on ciclosporin with initial improvement, but uptitration was limited to 3 mg kg−1 per day due to the development of significant renal impairment, which required medical admission. Treatment was switched to adalimumab fortnightly. His ulcers progressed aggressively despite an increased dose up to 80 mg weekly. The ulcers were also unresponsive to oral steroids (1 mg kg−1 per day), which were poorly tolerated in the context of his comorbidities. He was commenced on anakinra (100 mg daily), a recombinant interleukin-1 inhibitor, and initial monthly monitoring of neutrophils was carried out. Combined with ongoing lower-limb wound care and high-grade compression, anakinra has resulted in significant ulcer improvement and gradual healing, and has been well tolerated. After 14 months of treatment, all areas of ulceration are almost completely healed with one area of mild overgranulation, currently being treated with topical clobetasol propionate. This case highlights the difficulties in treating PG, as side-effects of medications must be balanced with systemic comorbidities. It also reveals the importance of regular wound care and lower-limb compression in the setting of ulcers at this site. Anakinra represents a potentially effective treatment option with a relatively low side-effect profile.
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2024-01-30 | What can inherited immunodeficiencies reveal about pyoderma gangrenosum?
Pyoderma gangrenosum (PG) is a rare ulcerative neutrophilic dermatosis that is occasionally associated with primary immunodeficiency. Though contributions from dysregulation of the innate immune system, neutrophil dysfunction and genetic predisposition have been postulated, the precise pathogenesis of PG has not yet been elucidated. This article reviews reported cases of coexisting PG and primary immunodeficiency in order to gain insight into the complex pathophysiology of PG. Our findings suggest that variations in genes such as RAG1, ITGB2, IRF2BP2 and NFκB1 might play a role in genetically predisposing patients to develop PG. These studies support the feasibility of the role of somatic gene variation in the pathogenesis of PG which warrants further exploration to guide targeted therapeutics.
2016-05-09 | Gene Therapy for Pyoderma Gangrenosum: Optimal Transfection Conditions and Effect of Drugs on Gene Delivery in the HaCaT Cell Line Using Cationic Liposomes
Pyoderma gangrenosum (PG) is a rare ulcerative skin disease, currently treated empirically with immunosuppression. PG is a good target for gene therapy since the skin is easily accessible. This study used the FDA-approved vector Lipofectamine® 2000 to investigate in vitro transfection of skin keratinocytes. The aim was to determine an optimum transfection protocol, including the effect of drugs currently used to treat PG on the efficiency of gene transfer, since gene therapy is unlikely to be used as monotherapy.Cells of the HaCaT line were transfected with the lacZ reporter gene, and transgene expression was measured after a given time period. Conditions tested were: relative concentrations of DNA and Lipofectamine®, time from transfection to measurement of expression, pH, and exposure to clinically relevant drugs (hydrocortisone, methotrexate, infliximab).The greatest levels of β-galactosidase expression were observed using a DNA:Lipofectamine® ratio of 1:5 (μg/μl) on day 3 after transfection, using culture medium at pH 7, and in the presence of hydrocortisone. Transfection efficiency was reduced by the presence of methotrexate and not significantly affected by infliximab.Gene therapy is a potential future strategy for the management of PG; this study is a step towards the development of a topical gene-based agent.
2000-04-01 | Interleukin-8 Overexpression Is Present in Pyoderma Gangrenosum Ulcers and Leads to Ulcer Formation in Human Skin Xenografts
Interleukin-8 (IL-8) is a potent chemotactic polypeptide for neutrophils. However, the role of this cytokine during inflammation remains unclear. Skin specimens from patients with pyoderma gangrenosum demonstrated IL-8 overexpression in skin ulcers, which suggests a role for IL-8 in the development of the disease. We therefore constructed a recombinant adenovirus expressing the complementary deoxyribonucleic acid encoding human IL-8 (IL-8/Ad5) that induces a 2000-fold increase in IL-8 expression of infected human fibroblasts in vitro. Human skin engrafted to severe combined immunodeficiency mice and then injected with the recombinant virus demonstrated erythema, an intense perivascular infiltration of neutrophils, and extravasation of erythrocytes after 8 hours. By 12 hours after injection, neutrophils had accumulated beneath the epidermis, which then necrotized, and one or more ulcers that remained for approximately 2 weeks were observed. Clinically and histologically, the ulcers resembled pyoderma gangrenosum. These clinical and experimental findings suggest an etiologic role of IL-8 in the pathogenesis of pyoderma gangrenosum.
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Drug Discovery Landscape
6 orphan drug designations for Pyoderma gangrenosum.
6 orphan drug designations for Pyoderma gangrenosum.
Drug | Therapy type | Regulator | Orphan designation | Approval | Sponsor |
|---|---|---|---|---|---|
infliximab | antibodies | FDA | 2025-11-09 | — | ODDIFACT SAS |
spesolimab-sbzo | antibodies | FDA | 2025-04-16 | — | LEO Pharma Inc. |
Vilobelimab | antibodies | EMA | 2022-07-18 | — | InflaRx GmbH |
Vilobelimab | antibodies | FDA | 2022-06-27 | — | InflaRx N.V. |
Telacebec | — | FDA | 2021-01-13 | — | The Global Alliance for TB Drug Development, Inc. |
gevokizumab | antibodies | FDA | 2014-02-21 | — | XOMA (US) LLC |
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