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Treatment of Thalidomide Resistant Pyoderma Gangrenosum with Etenercept
Rita Guedes
; Dermatology Department Centro Hospitalar de Vila Nova de Gaia Rua Conceição Fernandes 4434 Vila Nova de Gaia Portugal
Ana Moreira
; Dermatology Department Centro Hospitalar de Vila Nova de Gaia Rua Conceição Fernandes 4434 Vila Nova de Gaia Portugal
Nuno Menezes
; Dermatology Department Centro Hospitalar de Vila Nova de Gaia Rua Conceição Fernandes 4434 Vila Nova de Gaia Portugal
Armando Baptista
; Dermatology Department Centro Hospitalar de Vila Nova de Gaia Rua Conceição Fernandes 4434 Vila Nova de Gaia Portugal
Paulo Varela
; Dermatology Department Centro Hospitalar de Vila Nova de Gaia Rua Conceição Fernandes 4434 Vila Nova de Gaia Portugal
Abstract
Tumor necrosis factor alfa (TNF-α) is a cytokine with a central
role in inflammation. Its blockade can be achieved by using specific
inhibitors like etanercept. At present, etanercept is approved for rheumatoid
arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic
arthritis and psoriasis treatment. However, it has been used with
promising results in other inflammatory dermatoses. A case is presented
of a 54-year-old man diagnosed with pyoderma gangrenosum. He completed
treatment with oral prednisolone with favorable outcome, but
with recurrence after glucocorticoid therapy withdrawal. Thalidomide
was introduced, but after complaints of glove and sock paresthesia and
hypoesthesia, the drug was discontinued. Taking into account the favorable
outcome with thalidomide and the necessity of drug withdrawal,
it was decided to introduce therapy acting on the same step in the inflammation
cascade. In this regard, etanercept was initiated. The aim of
this article is to present an alternative therapy for refractory pyoderma
gangrenosum, along with a literature review.
Keywords
pyoderma gangrenosum; thalidomide; etanercept; TNF-α
Hrčak ID:
89117
URI
Publication date:
14.10.2012.
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