Recalcitrant and severe pyoderma gangrenosum attributable to levamisole-adulterated cocaine and treated successfully with oral tofacitinib

Pyoderma gangrenosum is a rare, inflammatory, neutrophilic dermatosis that is a diagnosis of exclusion. We present a unique case of recalcitrant pyoderma gangrenosum attributable to levamisole-adulterated cocaine with variable, nonsustained responses to several systemic immunosuppressants and ultimate remission with oral tofacitinib.