array:24 [ "pii" => "S2387020623003339" "issn" => "23870206" "doi" => "10.1016/j.medcle.2023.04.024" "estado" => "S300" "fechaPublicacion" => "2023-09-08" "aid" => "6288" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2023" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2023;161:226-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0025775323002452" "issn" => "00257753" "doi" => "10.1016/j.medcli.2023.04.029" "estado" => "S300" "fechaPublicacion" => "2023-09-08" "aid" => "6288" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2023;161:226-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>" "titulo" => "Tratamiento del pioderma gangrenoso con guselkumab en condiciones diferentes a las autorizadas en la ficha técnica" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "226" "paginaFinal" => "227" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Off-label use of guselkumab for pyoderma gangrenosum" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 896 "Ancho" => 1340 "Tamanyo" => 172285 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">a) Antes de iniciar tratamiento con guselkumab: lesión ulcerada de gran tamaño con eritema en el tercio inferior de la pierna. b) Tras recibir inducción y la primera dosis de mantenimiento de guselkumab: desaparición total del eritema de la pierna y cicatrización de la úlcera, apreciándose tan solo lesiones residuales postinflamatorias.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Laura Villaverde Piñeiro, Manuel Loureiro Martínez, Ana Isabel Cachafeiro Pin" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Laura" "apellidos" => "Villaverde Piñeiro" ] 1 => array:2 [ "nombre" => "Manuel" "apellidos" => "Loureiro Martínez" ] 2 => array:2 [ "nombre" => "Ana Isabel" "apellidos" => "Cachafeiro Pin" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020623003339" "doi" => "10.1016/j.medcle.2023.04.024" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623003339?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775323002452?idApp=UINPBA00004N" "url" => "/00257753/0000016100000005/v3_202312011048/S0025775323002452/v3_202312011048/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2387020623003340" "issn" => "23870206" "doi" => "10.1016/j.medcle.2023.04.025" "estado" => "S300" "fechaPublicacion" => "2023-09-08" "aid" => "6292" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2023;161:227-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "<span class="elsevierStyleItalic">Neisseria gonorrhoeae</span> arthritis: Study of 8 cases" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "227" "paginaFinal" => "228" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Artritis por <span class="elsevierStyleItalic">Neisseria gonorrhoeae</span>: estudio de 8 casos" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pablo Andújar Brazal, Eduardo Flores Fernández, Juan José Alegre Sancho" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Pablo" "apellidos" => "Andújar Brazal" ] 1 => array:2 [ "nombre" => "Eduardo" "apellidos" => "Flores Fernández" ] 2 => array:2 [ "nombre" => "Juan José" "apellidos" => "Alegre Sancho" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775323002531" "doi" => "10.1016/j.medcli.2023.04.033" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775323002531?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623003340?idApp=UINPBA00004N" "url" => "/23870206/0000016100000005/v5_202401300721/S2387020623003340/v5_202401300721/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2387020623003327" "issn" => "23870206" "doi" => "10.1016/j.medcle.2023.04.023" "estado" => "S300" "fechaPublicacion" => "2023-09-08" "aid" => "6287" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2023;161:225-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Familial idiopathic tracheal subglottic stenosis: Description of three cases" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "225" "paginaFinal" => "226" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Estenosis subglótica traqueal idiopática familiar: descripción de tres casos" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1656 "Ancho" => 2007 "Tamanyo" => 255921 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0345" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) Sagittal section of the neck CT showing tracheal stenosis (arrow) of case 1. B) Flow/volume loop with fixed airflow obstruction morphology of the case 3. C,D) Endoscopic images showing subglottic stenosis in case 1 and case 3, respectively.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Esperanza Salcedo Lobera, Francisco M. Páez Codeso, Antonio Dorado Galindo" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Esperanza" "apellidos" => "Salcedo Lobera" ] 1 => array:2 [ "nombre" => "Francisco M." "apellidos" => "Páez Codeso" ] 2 => array:2 [ "nombre" => "Antonio" "apellidos" => "Dorado Galindo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775323002488" "doi" => "10.1016/j.medcli.2023.04.028" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775323002488?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623003327?idApp=UINPBA00004N" "url" => "/23870206/0000016100000005/v5_202401300721/S2387020623003327/v5_202401300721/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the editor</span>" "titulo" => "Off-label use of guselkumab for pyoderma gangrenosum" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">Dear Editor,</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "226" "paginaFinal" => "227" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Laura Villaverde Piñeiro, Manuel Loureiro Martínez, Ana Isabel Cachafeiro Pin" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Laura" "apellidos" => "Villaverde Piñeiro" "email" => array:1 [ 0 => "lvillaverdepineiro@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Manuel" "apellidos" => "Loureiro Martínez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Ana Isabel" "apellidos" => "Cachafeiro Pin" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Farmacia, Hospital Público de Monforte de Lemos, Lugo, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Público de Monforte de Lemos, Lugo, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Farmacia, Hospital Público de la Mariña, Lugo, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento del pioderma gangrenoso con guselkumab en condiciones diferentes a las autorizadas en la ficha técnica" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 896 "Ancho" => 1340 "Tamanyo" => 172864 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0405" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">a) Before starting treatment with guselkumab: a large, ulcerated lesion with erythema in the lower third of the leg. b) After receiving induction and the first maintenance dose of guselkumab: complete disappearance of the erythema of the leg and healing of the ulcer, with only residual post-inflammatory lesions being observed.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis. It presents as a chronic and ulcerative disease of the skin, either independently or associated with certain systemic pathologies such as inflammatory bowel disease, rheumatoid arthritis and haematological disorders.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The most common initial presentation is an inflammatory pustule, most frequently located on the shin, which progresses to a boggy ulcer with a pitted violaceous border surrounding a purulent base. These ulcers are painful, fast-growing, and necrotising. Other variants of the lesions are bullous, pustular, vegetative, site-specific, and granulomatous.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">There is no widely accepted definitive diagnostic criteria and there is no standard treatment. Topical, intralesional or systemic glucocorticoids may be used, and associated or not with immunosuppressants. When the control is insufficient, the use of biologics emerges as a treatment option, as it has been demonstrated that an overexpression of various cytokines appears in PG, among which the following stand out: IL-1β, IL-1α, TNF-α, IL-8, IL-12, IL-17 and IL-23.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">We present the case of a 72-year-old woman diagnosed with PG who was in follow-up by the dermatology clinic since 2008.</p><p id="par0025" class="elsevierStylePara elsevierViewall">She was also in follow-up by the pain unit due to musculoskeletal pain in the spine and ulcers in the left lower limb, all due to PG.</p><p id="par0030" class="elsevierStylePara elsevierViewall">She had received systemic treatment with oral glucocorticoids, minocycline, azathioprine, cyclosporine, and various biologics: infliximab 5<span class="elsevierStyleHsp" style=""></span>mg/kg (400<span class="elsevierStyleHsp" style=""></span>mg) intravenously every 8 weeks (2005–2007), etanercept 50<span class="elsevierStyleHsp" style=""></span>mg subcutaneous (SC) twice weekly (2007), adalimumab 40<span class="elsevierStyleHsp" style=""></span>mg weekly and 40<span class="elsevierStyleHsp" style=""></span>mg every 2 weeks SC (2007–2009), retreatment with infliximab (2009–2010) and ustekinumab 90<span class="elsevierStyleHsp" style=""></span>mg every 12 weeks SC from October 2017 to June 2022.</p><p id="par0035" class="elsevierStylePara elsevierViewall">She was currently receiving 10<span class="elsevierStyleHsp" style=""></span>mg prednisone daily orally and 20<span class="elsevierStyleHsp" style=""></span>mg methotrexate SC weekly, without remission of the disease, with a large, ulcerated lesion with erythema in the lower third of the leg (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">In this context, it was decided to request guselkumab under conditions other than those authorised in its Summary of Product Characteristic sheet, following the dosage regimen indicated for plaque psoriasis: 100<span class="elsevierStyleHsp" style=""></span>mg SC injection at weeks 0 and 4, followed by a maintenance dose of 100<span class="elsevierStyleHsp" style=""></span>mg every 8 weeks.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> She began treatment in June 2022, meeting the criteria established in Royal Decree 1015/2009, of June 19, which regulates the availability of medical products in special situations, after the approval of the General Sub-directorate of Pharmacy of Galicia as it was referring to a drug with a high health and economic impact.</p><p id="par0045" class="elsevierStylePara elsevierViewall">After receiving the induction regimen and the first maintenance dose, the total disappearance of the erythema of the leg and the healing of the ulcer were observed, with only residual post-inflammatory lesions being observed (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><p id="par0050" class="elsevierStylePara elsevierViewall">There is only one case published of a 60-year-old woman with characteristics similar to our patient, who had received prior treatment with two anti-TNF agents (infliximab and adalimumab) and ustekinumab. Due to previous favourable response to IL 12 and 23 blockade, guselkumab 100<span class="elsevierStyleHsp" style=""></span>mg was administered monthly, a regimen not included in any of its authorised indications, with significant clinical improvement, obtaining 95% re-epithelialization of the ulcer 3 months after the start of treatment. The response was persistent, as expected with IL-23 blockade, and was maintained after 15 months of treatment.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">In our case, using the authorised dosage for the indication of plaque psoriasis, a good clinical result has been achieved, demonstrating that, in addition to it being an easier regimen for the patient, it is also more cost-effective. At the same time, the treatment has turned out to be safe and well tolerated, as no adverse reactions to it have been reported.</p><p id="par0060" class="elsevierStylePara elsevierViewall">This clinical case exemplifies how to triangulate clinical needs, the sustainability of the system and the comfort of the patient, working in an interdisciplinary way in the search for the best possible alternative, allowing the use of guselkumab despite being an off-label option and verifying its usefulness in clinical practice.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical considerations</span><p id="par0065" class="elsevierStylePara elsevierViewall">Informed consent was obtained from the patient for the publication of this scientific letter.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Author contributions</span><p id="par0070" class="elsevierStylePara elsevierViewall">All authors have made substantial contributions in each of the following aspects: data acquisition and analysis, draft of the article or critical review of the intellectual content, and final approval of the version being submitted.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Ethical considerations" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Author contributions" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 896 "Ancho" => 1340 "Tamanyo" => 172864 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0405" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">a) Before starting treatment with guselkumab: a large, ulcerated lesion with erythema in the lower third of the leg. b) After receiving induction and the first maintenance dose of guselkumab: complete disappearance of the erythema of the leg and healing of the ulcer, with only residual post-inflammatory lesions being observed.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment options for pyoderma gangrenosum" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.R. Quist" 1 => "L. Kraas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ddg.13173" "Revista" => array:6 [ "tituloSerie" => "J Dtsch Dermatol Ges" "fecha" => "2017" "volumen" => "15" "paginaInicial" => "34" "paginaFinal" => "40" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28140549" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pyoderma gangrenosum: challenges and solutions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Gameiro" 1 => "N. Pereira" 2 => "J.C. Cardoso" 3 => "M. Gonçalo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2147/CCID.S61202" "Revista" => array:6 [ "tituloSerie" => "Clin Cosmet Investig Dermatol" "fecha" => "2015" "volumen" => "8" "paginaInicial" => "285" "paginaFinal" => "293" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26060412" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pyoderma Gangrenosum: An Update on Pathophysiology, Diagnosis and Treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Alavi" 1 => "L.E. French" 2 => "M.D. Davis" 3 => "A. Brassard" 4 => "R.S. Kirsner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s40257-017-0251-7" "Revista" => array:6 [ "tituloSerie" => "Am J Clin Dermatol" "fecha" => "2017" "volumen" => "18" "paginaInicial" => "355" "paginaFinal" => "372" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28224502" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Ficha técnica AGEMED de Tremfya ® [Accessed 10 June 2022]. Available from: <a target="_blank" href="https://cima.aemps.es/cima/dochtml/ft/1171234001/FT_1171234001.html">https://cima.aemps.es/cima/dochtml/ft/1171234001/FT_1171234001.html</a>." ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guselkumab as a treatment option for recalcitrant pyoderma gangrenosum" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C. Baier" 1 => "O. Barak" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jdcr.2020.12.005" "Revista" => array:6 [ "tituloSerie" => "JAAD case reports" "fecha" => "2020" "volumen" => "8" "paginaInicial" => "43" "paginaFinal" => "46" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33490346" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000016100000005/v5_202401300721/S2387020623003339/v5_202401300721/en/main.assets" "Apartado" => array:4 [ "identificador" => "43309" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000016100000005/v5_202401300721/S2387020623003339/v5_202401300721/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623003339?idApp=UINPBA00004N" ]
Journal Information
Vol. 161. Issue 5.
Pages 226-227 (September 2023)
Share
Download PDF
More article options
Vol. 161. Issue 5.
Pages 226-227 (September 2023)
Letter to the editor
Off-label use of guselkumab for pyoderma gangrenosum
Tratamiento del pioderma gangrenoso con guselkumab en condiciones diferentes a las autorizadas en la ficha técnica
Visits
3
This item has received
Article information
These are the options to access the full texts of the publication Medicina Clínica (English Edition)
Subscriber
Subscribe
Purchase
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail