Guselkumab as a treatment option for recalcitrant pyoderma gangrenosum

Pyoderma gangrenosum (PG) is a rare neutrophilic cutaneous disorder characterized by single or multiple inflammatory nodules, papules, or pustules, which rapidly ulcerate with undermined borders, tenderness, and cribriform scarring upon healing.1 It is a challenging condition to identify, given initial misdiagnosis and mismanagement with physical debridement, propensity for superinfection, and rarity.2 Furthermore, once the correct diagnosis is recognized, therapeutic challenges include promptly implementing an effective treatment to prevent rapid progression with concomitant morbidity and distress to the patient.