Paradoxical pyoderma gangrenosum secondary to adalimumab successfully treated with methotrexate: A case report

Pyoderma gangrenosum (PG) is a rare inflammatory skin disorder, categorised under neutrophilic dermatoses. It can be idiopathic or associated with underlying conditions like inflammatory bowel disease, autoimmune diseases, and certain cancers. Some medications, including tumour necrosis factor-alpha inhibitors like adalimumab, can also induce this paradoxical reaction. We describe the case of a 19-year-old male with adalimumab-induced PG, which was successfully treated with methotrexate, contributing to the understanding of drug-induced PG and alternative treatment strategies.