Pulmonary Involvement Successfully Treated With Infliximab in a Patient With Pyoderma Gangrenosum and Rheumatoid...

Area of Science:

• Rheumatology
• Pulmonology
• Dermatology

Background:

• Pulmonary involvement in pyoderma gangrenosum (PG) is uncommon.
• Few cases link PG and rheumatoid arthritis (RA), with rare instances of pulmonary manifestations.

Purpose of the Study:

• To report a rare case of simultaneous pulmonary nodules and cutaneous PG in a patient with RA.
• To evaluate the efficacy of infliximab (IFX) in treating pulmonary PG and rheumatoid nodules.

Main Methods:

• Case study of a 72-year-old woman with RA presenting with cavitary pulmonary nodules and worsening cutaneous PG.
• Diagnostic procedures included bronchoscopy and video-assisted thoracoscopic surgery.
• Histopathological evaluation and differential diagnosis considered PG-related lesions and rheumatoid nodules.

Main Results:

• The patient developed multiple cavitary pulmonary nodules alongside worsening cutaneous PG.
• Histopathology showed nonspecific findings, ruling out infection.
• Infliximab (IFX) treatment led to successful management of both pulmonary and cutaneous manifestations.

Conclusions:

• This case highlights the diagnostic challenges of pulmonary involvement in patients with PG and RA.
• Tumor necrosis factor-α inhibitors, such as IFX, may represent a promising therapeutic option for select patients.