dramatic response of rapid progressive atypical pyoderma gangrenosum to infliximab in a patient with ulcerative colitis

Pyoderma gangrenosum (pg) is a relatively uncommon disorder associated with autoimmune and inflammatory conditions, including inflammatory bowel disease (ibd). pg’s prevalence ranges from 0.4 - 2.6% in patients with ibd. we describe a 34-year-old man with ulcerative colitis (uc) who was referred to our center with some small follicular and pustular lesions rapidly progressing into a painful necrotic ulcer in the right axilla. the ulcer was not responsive to broad spectrum antibiotics and topical cytotoxic agents like tacrolimus. finally, a dramatic response was observed after initiating anti-tumor necrosis factor (anti-tnf) treatment with infliximab (10 mg/kg) within a week. a significant reduction in size and necrotic tissue was achieved one month after the index date of the prescription of infliximab. a 2-month follow-up of the patient revealed complete healing of the lesion.