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Letters |7 July 2015

Anakinra Improves Pyoderma Gangrenosum in Psoriatic Arthritis: A Case Report

Marie Acquitter, MD; Patrice Plantin, MD; Ingrid Kupfer, MD; Henri Auvinet, BS; Thierry Marhadour, MD

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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 positive for HLA-B27 antigen. Computed tomography documented sacroiliitis typical of psoriatic arthritis. The patient had no extra-articular damage associated with her rheumatism, which had been treated with methotrexate since diagnosis. She also had previously received prednisone, sulfasalazine, and infliximab, but treatment with these agents was discontinued in 2004 because of infection after knee arthroplasty.
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Acquitter M, Plantin P, Kupfer I, Auvinet H, Marhadour T. Anakinra Improves Pyoderma Gangrenosum in Psoriatic Arthritis: A Case Report. Ann Intern Med. ;163:70–71. doi: 10.7326/L15-5107

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Published: Ann Intern Med. 2015;163(1):70-71.

DOI: 10.7326/L15-5107

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