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Peristomal Pyoderma Gangrenosum Responding to Risankizumab
Maximillian A Weigelt1, Robert S Kirsner
1In Miami, Florida, Maximillian A. Weigelt, MD, is Clinical Research Fellow, Dr Phillip Frost Department of Dermatology & Cutaneous Surgery University of Miami Miller School of Medicine; and Robert S. Kirsner, MD, PhD, is Chairman and Harvey Blank Professor, Dr Phillip Frost Department of Dermatology & Cutaneous Surgery, Professor of Public Health Sciences, University of Miami Miller School of Medicine, and Director, University of Miami Hospital and Clinics Wound Center. Acknowledgments: This manuscript describes off-label product use: risankizumab for pyoderma gangrenosum. The authors have disclosed no financial relationships related to this article. Submitted May 6, 2020; accepted in revised form June 19, 2020.
Abstract:
Evidence to support available therapies for pyoderma gangrenosum (PG) is limited. Many patients do not respond to topical therapies such as tacrolimus or topical steroids. Currently favored oral systemic treatments (eg, cyclosporine and steroids) achieve complete remission in only 50% of patients and have unfavorable adverse effect profiles. There is a growing body of evidence to support biologic agents for the treatment of PG, but their exact role remains unclear. Here the authors present a patient with peristomal PG, the first reported case of PG responding to treatment with risankizumab, an anti-interleukin 23 monoclonal antibody. Risankizumab may represent an effective and relatively safe treatment for PG that merits additional exploration in prospective, controlled studies.
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