Case Report: Successful treatment of pyoderma gangrenosum-like granulomatous liver disease without skin lesions using a TNF-alpha inhibitor - Takeaways - MDSpire
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Case Study: Effective Management of Granulomatous Liver Disease Resembling Pyoderma Gangrenosum Without Associated Skin Lesions Using a TNF-alpha Inhibitor

  • By

  • Isabelle Panne

  • Matthias Matter

  • Jürg Vosbeck

  • Matthias von Rotz

  • Alexandra Steinemann

  • Marten Trendelenburg

  • Markus H. Heim

  • Peter Schirmacher

  • Andrea De Gottardi

  • Ansgar W. Lohse

  • Luigi M. Terracciano

  • Christine Bernsmeier

  • June 15, 2026

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  • 1

    A 73-year-old man presented with isolated hepatic and ocular involvement of pyoderma gangrenosum without skin lesions, highlighting diagnostic challenges.

  • 2

    The patient exhibited elevated liver enzymes and CRP, alongside imaging revealing disseminated nodular liver lesions and histological findings of granulomatous inflammation.

  • 3

    Extensive testing excluded common infectious, malignant, and autoimmune causes, reinforcing the rarity of hepatic involvement in pyoderma gangrenosum.

  • 4

    Immunosuppressive treatment with prednisone followed by infliximab led to complete clinical and biochemical remission in the patient.

  • 5

    This case emphasizes the systemic nature of pyoderma gangrenosum and the need for awareness of extracutaneous manifestations in clinical practice.

Original Source(s)

Case Report: Successful treatment of pyoderma gangrenosum-like granulomatous liver disease without skin lesions using a TNF-alpha inhibitor

  • by Isabelle Panne, Matthias Matter, Jürg Vosbeck, Matthias von Rotz, Alexandra Steinemann, Marten Trendelenburg, Markus H. Heim, Peter Schirmacher, Andrea De Gottardi, Ansgar W. Lohse, Luigi M. Terracciano, Christine Bernsmeier

  • June 15, 2026

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