Related Experiment Video
Updated: Jun 28, 2025

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Risankizumab as a Therapeutic Approach for Recalcitrant Pyoderma Gangrenosum
Alessandra Michelucci1, Flavia Manzo Margiotta, Giammarco Granieri
1In the Department of Dermatology, University of Pisa, Italy, Alessandra Michelucci, MD; Flavia Manzo Margiotta, MD; Giammarco Granieri, MD; Giorgia Salvia, MD; Cristian Fidanzi, MD; and Matteo Bevilacqua, MD, are Dermatology Residents; Salvatore Panduri, MD, is Specialized Physician; Marco Romanelli, MD, PhD, is Full Professor; and Valentina Dini, MD, PhD, is Associate Professor. Acknowledgments: This manuscript describes off-label product use: risankizumab for pyoderma gangrenosum. The authors have disclosed no financial relationships related to this article. Submitted January 13, 2023; accepted in revised form June 23, 2023.
Risankizumab, an anti-interleukin-23 monoclonal antibody (mAb), effectively treated two complex pyoderma gangrenosum (PG) cases. This therapy, combined with local wound care, showed efficacy and safety in managing refractory PG.
Area of Science:
- Dermatology
- Immunology
Background:
- Pyoderma gangrenosum (PG) is a challenging neutrophilic dermatosis.
- Current treatments involve corticosteroids and immunosuppressants, with emerging research on monoclonal antibodies (mAbs).
Purpose of the Study:
- To evaluate the efficacy and safety of risankizumab, an anti-interleukin-23 mAb, in managing complex pyoderma gangrenosum cases.
Main Methods:
- Two patients with refractory PG received off-label risankizumab (150 mg subcutaneously) alongside existing immunosuppressive therapies.
- Treatment included local ulcer management based on TIME principles.
- Dosage: initial, week 4, then every 10 weeks.
Main Results:
- Complete clinical resolution achieved by week 24 (patient 1) and week 16 (patient 2).
- Remission was maintained until week 40 without adverse effects or recurrence.
- Demonstrated efficacy and safety of risankizumab in multirefractory PG.
Conclusions:
- Risankizumab is a viable therapeutic option for complex, treatment-resistant pyoderma gangrenosum.
- Combination with personalized local wound care enhances treatment outcomes.
- Further research into mAbs for PG management is warranted.
Related Concept Videos
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
Gastritis III: Clinical Manifestations and Management
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...

