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Her methotrexate was held off when she developed severe pneumonia and she then received a trial of intravenous immunoglobulins (IVIG) for her recurrent leg ulcers. Unfortunately, she failed to respond to IVIG. Her ulcers eventually responded to six doses of monthly intravenous cyclophosphamide induction. Although CS is not an antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis, we used pulse cyclophosphamide, based on the experience of cyclophosphamide efficacy in severe ANCA-associated vasculitis (AAV). Following induction, both diseases currently remain under control with azathioprine as maintenance treatment.<\/jats:p>","DOI":"10.1136\/bcr-2017-223876","type":"journal-article","created":{"date-parts":[[2018,6,20]],"date-time":"2018-06-20T03:55:10Z","timestamp":1529466910000},"page":"bcr-2017-223876","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Cogan\u2019s syndrome with pyoderma gangrenosum: management of two uncommon disorders with aggressive presentation in a patient"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6267-0550","authenticated-orcid":false,"given":"Ezolene Pei-Chin","family":"Chua","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard B","family":"Mallett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Dahiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,6,19]]},"reference":[{"key":"2025042703562226000_2018.jun18_1.bcr-2017-223876.1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ket445"},{"key":"2025042703562226000_2018.jun18_1.bcr-2017-223876.2","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1945.00890140064007"},{"key":"2025042703562226000_2018.jun18_1.bcr-2017-223876.3","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1949.00900050045004"},{"key":"2025042703562226000_2018.jun18_1.bcr-2017-223876.4","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-198011000-00003"},{"key":"2025042703562226000_2018.jun18_1.bcr-2017-223876.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2012.07.012"},{"key":"2025042703562226000_2018.jun18_1.bcr-2017-223876.6","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1055\/s-2007-1008327","article-title":"[Serum antibodies against corneal and internal ear tissues in Cogan\u2019s syndrome]","volume":"63","author":"Arnold","year":"1984","journal-title":"Laryngol Rhinol Otol"},{"key":"2025042703562226000_2018.jun18_1.bcr-2017-223876.7","doi-asserted-by":"publisher","DOI":"10.3109\/00016488509108935"},{"key":"2025042703562226000_2018.jun18_1.bcr-2017-223876.8","doi-asserted-by":"publisher","DOI":"10.1080\/00016489950180748"},{"key":"2025042703562226000_2018.jun18_1.bcr-2017-223876.9","doi-asserted-by":"publisher","DOI":"10.1002\/art.37715"},{"key":"2025042703562226000_2018.jun18_1.bcr-2017-223876.10","doi-asserted-by":"publisher","DOI":"10.2165\/11595240-000000000-00000"},{"key":"2025042703562226000_2018.jun18_1.bcr-2017-223876.11","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-012-8351-x"},{"key":"2025042703562226000_2018.jun18_1.bcr-2017-223876.12","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(76)90722-1"},{"key":"2025042703562226000_2018.jun18_1.bcr-2017-223876.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2014.01.002"},{"key":"2025042703562226000_2018.jun18_1.bcr-2017-223876.14","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keh228"},{"key":"2025042703562226000_2018.jun18_1.bcr-2017-223876.15","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.jpeds.2011.07.051","article-title":"Clinical features and outcome of Cogan syndrome","volume":"160","author":"Pagnini","year":"2012","journal-title":"J Pediatr"},{"key":"2025042703562226000_2018.jun18_1.bcr-2017-223876.16","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1046\/j.1365-2230.1998.00390.x","article-title":"Pyoderma gangrenosum complicating Cogan\u2019s syndrome","volume":"23","author":"Boulinguez","year":"1998","journal-title":"Clin Exp Dermatol"},{"key":"2025042703562226000_2018.jun18_1.bcr-2017-223876.17","doi-asserted-by":"crossref","unstructured":"Solano-L\u00f3pez G , Montes-Torresa A , Tomero E , et al . 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