Navigating Therapeutic Challenges of Pyoderma Gangrenosum in Felty's Syndrome: A Case Report and Literature Review

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by painful skin ulcers. Treatment typically involves systemic corticosteroids, calcineurin inhibitors, or tumor necrosis factor-alpha inhibitors. Currently, treatment guidelines are not well established, making it important to consider alternative options in complicated cases. We report the case of a 52-year-old female with rheumatoid arthritis (RA) and a history of Felty's syndrome (FS) who developed PG and subsequently developed neutropenia due to azathioprine. The patient achieved remission with the use of dapsone and filgrastim. This treatment may be effective as an alternative for patients with RA and FS.