{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T16:38:13Z","timestamp":1789749493562,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:00:00Z","timestamp":1776470400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:00:00Z","timestamp":1776470400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The therapeutic management of pyoderma gangrenosum (PG) is challenging. Conventional therapies, including systemic corticosteroids and cyclosporine, are limited by incomplete responses, frequent relapses, and cumulative toxicity. Emerging evidence supports a pathogenic role of the interleukin (IL)\u201023\/IL\u201017 axis in PG, suggesting selective IL\u201023 inhibition as an appealing therapeutic approach. This study assessed the effectiveness, safety, steroid\u2010sparing potential, and predictors of response to selective IL\u201023 inhibitors in conventional treatment\u2010refractory PG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective study included adult patients with refractory PG or intolerant to conventional systemic therapies, treated with selective IL\u201023 inhibitors (guselkumab, risankizumab, or tildrakizumab). Clinical assessments were performed at baseline and during follow\u2010up (1, 3, 6, 12\u2009months, and last observation), evaluating ulcer area, number of lesions, ulcer depth, border wound bed characteristics, Investigator's Global Assessment for PG (IGAPg), and pain intensity assessed by the Numerical Rating Scale (NRS). Longitudinal changes were analyzed using non\u2010parametric tests for repeated measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Selective IL\u201023 inhibition in 18 patients was associated with a progressive reduction in total ulcer area, significant from 1\u2009month onward (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0069; all subsequent\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.0003). The number of active ulcers did not change at 1\u2009month (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.41) but significantly decreased from Month 3 onward (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004 to &lt;\u20090.001). Ulcer depth remained unchanged at 1\u2009month (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.41) and significantly improved from Month 3 onward (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01\u20130.046). Border\/perilesional inflammation and wound bed characteristics showed significant improvement at all follow\u2010up visits (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0008\u20130.034 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013\u20130.046, respectively). IGAPg score showed a significant and progressive improvement over time (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.027). Pain intensity showed a significant reduction during follow\u2010up (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004 to &lt;\u20090.001). A significant steroid\u2010sparing effect was observed, with a progressive reduction in median daily prednisone\u2010equivalent dose during follow\u2010up (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002\u20130.014). Guselkumab and risankizumab showed comparable efficacy (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.182). In univariate analysis, baseline ulcer depth was the only predictor of ulcer area reduction (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039). No unexpected safety signals were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Selective IL\u201023 inhibition appears to be a well\u2010tolerated therapeutic option for refractory PG, providing meaningful clinical improvement and a relevant steroid\u2010sparing effect. These findings support further controlled studies to define the role of IL\u201023 inhibitors within PG treatment algorithms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijd.70430","type":"journal-article","created":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T03:49:12Z","timestamp":1776570552000},"page":"2055-2065","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Selective\n                    <scp>IL<\/scp>\n                    \u201023 Inhibition in Conventional Treatment\u2010Refractory Pyoderma Gangrenosum: A Multicenter, Retrospective Study"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4374-802X","authenticated-orcid":false,"given":"Luca","family":"Bettolini","sequence":"first","affiliation":[{"name":"Dermatology Unit Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico  Milan Italy"},{"name":"Dermatology Department University of Brescia, ASST 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