Upadacitinib for Pyoderma Gangrenosum: A Case Report and Review of Emerging Evidence
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Keywords
pyoderma gangrenosum, Neutrophilic Dermatoses, Upadacitinib, JAK-1 Inhibitor
Abstract
Pyoderma gangrenosum (PG) is a rare, ulcerative neutrophilic dermatosis characterized by painful, rapidly progressive skin ulcers, most commonly affecting the lower extremities. Management typically involves systemic corticosteroids and immunosuppressive agents, which often induce initial improvement but are frequently limited by adverse effects and high relapse rates upon tapering. These challenges highlight the limitations of conventional therapies and underscore the urgent need for effective steroid-sparing alternatives.
We report the case of a young man with PG refractory to corticosteroid tapering and adjunctive therapies, who achieved complete remission following initiation of upadacitinib, a selective oral Janus kinase 1 (JAK-1) inhibitor. Treatment resulted in a rapid clinical response, sustained ulcer closure, and allowed for corticosteroid dose reduction.
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Ekaterina Korytnikova, Department of Medicine, Norwalk Hospital, Norwalk, CT, USA
Board-eligible Internal Medicine Physician
Charles L. Halasz, Department of Medicine, Norwalk Hospital, Norwalk, CT, USA; Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
Associate Professor at Columbia University, Department of Dermatology
Emanuela Sangeorzan, Department of Medicine, Norwalk Hospital, Norwalk, CT, USA
Medical Director of Wound Care