Intractable pyoderma gangrenosum in a Crohn's disease patient on vedolizumab

IBD: inflammatory bowel disease PG: pyoderma gangrenosum TNF-a: tumor necrosis factor alpha INTRODUCTION Pyoderma gangrenosum (PG) is a rare infiltrative neutrophilic dermatosis that characteristically presents with painful ulcers with violaceous, undermined borders on the lower extremities and less commonly presents with tender nodules or pustules. Along with erythema nodosum, PG is one of the most frequent extraintestinal manifestations of inflammatory bowel disease (IBD). Although it is a common extraintestinal manifestation of IBD, PG does not always resolve when a patient’s IBD is in remission, suggesting that PG may not be related to the activity of IBD. We report the first case, to our knowledge, of intractable PG in a patient whose gastrointestinal Crohn’s disease is well controlled on vedolizumab.