PYODERMA GANGRENOSUM ASSOCIATED WITH CHRONIC HEPATITIS C SUCCESSFULLY TREATED WITH ETANERCEPT

Abstract

Introduction: Pyoderma gangrenosum (PG) is an idiopathic, recurrent, neutrophilic and ulcerative skin disease.

Case report: A 43-year-old man with chronic hepatitis C and drugs addiction in the past presented with a 6-months history of painful, violaceus, suppurative and necrotic ulcers on his lower extremities and any skin area inju- red by needle stick. PG was the main diagnosis proposed. Histological examination of the lesion edge demonstrated microscopic changes compatible with PG. Laboratory and radiological evaluation findings were compatible with his chronic liver disease. The patient was treated, in different moments, with systemic steroids, cyclosporine, dapsone, and thalidomide, with no satisfactory response. A complete remission was achieved with etanercept. Twelve months later, there were no signals of skin lesions, relevant hepatic damages or increase in viral load.

Conclusion: Etanercept was a safe and effective therapeutic option.

KEYWORDS – Pyoderma Gangrenosum; Hepatitis C, Chronic; Thalidomide; Glucocorticoids; Receptors, Tumor Necro- sis Factor; Immunoglobulin G.