Anakinra Improves Pyoderma Gangrenosum in Psoriatic Arthritis: A Case Report
Authors: Marie Acquitter, Patrice Plantin, Ingrid Kupfer, Henri Auvinet, Thierry Marhadour
Journal: Annals of Internal Medicine (2015)

Letters7 July 2015Anakinra Improves Pyoderma Gangrenosum in Psoriatic Arthritis: A Case ReportMarie Acquitter, MD, Patrice Plantin, MD, Ingrid Kupfer, MD, Henri Auvinet, BS, and Thierry Marhadour, MDMarie Acquitter, MDFrom Centre Hospitalier Intercommunal de Cornouaille, Quimper, France, and Centre Hospitalier Régional Universitaire de la Cavale Blanche and Université Bretagne Occidentale, Brest, France., Patrice Plantin, MDFrom Centre Hospitalier Intercommunal de Cornouaille, Quimper, France, and Centre Hospitalier Régional Universitaire de la Cavale Blanche and Université Bretagne Occidentale, Brest, France., Ingrid Kupfer, MDFrom Centre Hospitalier Intercommunal de Cornouaille, Quimper, France, and Centre Hospitalier Régional Universitaire de la Cavale Blanche and Université Bretagne Occidentale, Brest, France., Henri Auvinet, BSFrom Centre Hospitalier Intercommunal de Cornouaille, Quimper, France, and Centre Hospitalier Régional Universitaire de la Cavale Blanche and Université Bretagne Occidentale, Brest, France., and Thierry Marhadour, MDFrom Centre Hospitalier Intercommunal de Cornouaille, Quimper, France, and Centre Hospitalier Régional Universitaire de la Cavale Blanche and Université Bretagne Occidentale, Brest, France.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5107 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Anakinra is an antagonist of the receptor for interleukin-1. Pyoderma gangrenosum is a poorly understood condition that causes necrosis of skin and other tissue.Objective: To report the first case to our knowledge of anakinra improving pyoderma gangrenosum in a patient with psoriatic arthritis.Case Report: We assumed the care of a 46-year-old white woman with a painful, deep ulcer in the left leg. She was diagnosed with plaque psoriasis at age 7 years and had experienced symmetrical, destructive axial and peripheral polyarthritis since age 18 years. She was negative for rheumatoid factor and anti–cyclic citrullinated peptide antibodies but ...References1. Brooklyn TN, Dunnill MG, Shetty A, Bowden JJ, Williams JD, Griffiths CE, et al. Infliximab for the treatment of pyoderma gangrenosum: a randomised, double blind, placebo controlled trial. Gut. 2006;55:505-9. [PMID: 16188920] CrossrefMedlineGoogle Scholar2. Dinarello CA, van der Meer JW. Treating inflammation by blocking interleukin-1 in humans. Semin Immunol. 2013;25:469-84. [PMID: 24275598] doi:10.1016/j.smim.2013.10.008 CrossrefMedlineGoogle Scholar3. Brenner M, Ruzicka T, Plewig G, Thomas P, Herzer P. Targeted treatment of pyoderma gangrenosum in PAPA (pyogenic arthritis, pyoderma gangrenosum and acne) syndrome with the recombinant human interleukin-1 receptor antagonist anakinra. Br J Dermatol. 2009;161:1199-201. [PMID: 19673875] doi:10.1111/j.1365-2133.2009.09404.x CrossrefMedlineGoogle Scholar4. Lin Z, Hegarty JP, Lin T, Ostrov B, Wang Y, Yu W, et al. Failure of anakinra treatment of pyoderma gangrenosum in an IBD patient and relevance to the PSTPIP1 gene [Letter]. Inflamm Bowel Dis. 2011;17:E41-2. [PMID: 21438098] doi:10.1002/ibd.21684 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Marie Acquitter, MD; Patrice Plantin, MD; Ingrid Kupfer, MD; Henri Auvinet, BS; Thierry Marhadour, MDAffiliations: From Centre Hospitalier Intercommunal de Cornouaille, Quimper, France, and Centre Hospitalier Régional Universitaire de la Cavale Blanche and Université Bretagne Occidentale, Brest, France.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0558. 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The expanding therapeutics of interleukin-1 blockadeEmerging drugs for psoriatic arthritisThe continuing evolution of targeted therapy for inflammatory skin diseaseNeutrophilic dermatoses and autoinflammatory diseases with skin involvement—innate immune disorders 7 July 2015Volume 163, Issue 1Page: 70-71KeywordsAcneDisclosureInflammatory bowel diseaseMethotrexateNecrosisPsoriatic arthritisPyodermaRheumatoid arthritisUlcersVasculitis ePublished: 7 July 2015 Issue Published: 7 July 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...