Adalimumab and Tofacitinib Combination Therapy for Pyoderma Gangrenosum: A Case Report.

INTRODUCTION

Pyoderma gangrenosum (PG) is a rare inflammatory skin disease causing progressive necrotizing ulcers with limited treatment options due to adverse effects and high recurrence rates.

CASE PRESENTATION: We present a case of a 70-year-old elderly patient diagnosed as PG, which was unresponsive to initial prednisolone treatment. After approximately 3 weeks of an individualized treatment regimen of adalimumab combined with tofacitinib, disease progression was halted, accompanied by a significant reduction in ulcer size, reduced exudation, and substantial pain relief. Subsequent tapering and discontinuation of prednisolone, followed by 6 weeks of combined adalimumab and tofacitinib and 8 weeks of tofacitinib monotherapy, resulted in complete ulcer healing by week 17. No recurrence of inflammatory activity was observed during the follow-up period of over 7 months.

CONCLUSION

This case highlights the successful and rapid efficacy of adalimumab and tofacitinib combination therapy for PG, offering a novel strategic reference for individualized treatment, particularly in recurrent or cases unresponsive to initial treatment.