Pyoderma gangrenosum (PG )is an ulcerating noninfectious disease of the skin seen in 1 to 5% of patients with in- flam matory boweldisease.The pathogenesis ofPG has yet to be determ ined but m ay be related to abnorm al Tcell responses and the production ofTNF-α,a powerfulproin- flam m atory cytokine.Inflixim ab,a chim eric m onoclonal antibody to TNF-α,has been approved forthe treatm entof Crohn s disease.W e presentfour patients with PG treated with Inflixim ab for fistulizing Crohn s in whom com plete healing ofPG was achieved.Four patients with active fis- tulizing Crohns disease and PG were treated.Allpatients were fem ales ranging in age from 48to 60years,with a m ean age of54years.Three offourpatientshad PG lesions located on the lowerextrem ities;one patienthad peristom al disease.All patients had at least colonic involvem ent of theirCrohn s.The patientsreceived eithera single infusion or a series ofthree 5m g /kg Inflixim ab infusions.Allfour patients dem onstrated rapid healing ofPG within 4weeksof the first infusion of Inflixim ab.PG healing followed im - provem ent in bowel disease.Com plete resolution without recurrence was noted in all patients.Rapid resolution of PG wasnoted in fourfem ale patientswith fistulizing Crohn s disease treated with Inflixim ab.H ealing was com plete, without recurrence.The anti-TNF-αproperties of Inflix- im ab suggest that healing m ay be m ediated by the drugs effect on cytokine pathways,perhaps by blunted T cell activation early in the inflam m atory cascade.W e suggest an independenteffectofInflixim ab on PG. Pyoderma gangrenosum (PG) is an ulcerating noninfectious disease of the skin seen in 1 to 5% of patients with in- flam matory boweldisease. The pathogenesis of PG has yet to be determined but m ay be related to abnorm al Tcell responses and the production of TNF- alpha, a powerful proinflammatory cytokine. flixim ab, a chim eric moclonal antibody to TNF-alpha, has been approved forthe treatm ent of Crohn’s disease. present present patients with PG treated with Inflixim ab for fistulizing Crohn s in whom com plete healing of PG was achieved. Patients with active fis- tulizing Crohns disease and PG were treated. Allpatients were fem ales ranging in age from 48 to 60 years, with am ean age of 54 years. Thhree offourpatientshad PG lesions located on the lowerextrem ities; one patienthad peristom al disease. All patients had at least colonic involvement of their Crohn’s disease. The patientsreceived eithera single infusion or a series of three 5m g / kg Inflixim ab infusions. All patients in on rapidrated hemi aling of PGs within 4 weeks of the first infusion of Inflixim ab. PG healing followed im - provem ent in bowel disease. Comm p resolution resolution without recurrence was noted in all patients. Rapid resolution of PG was noted in fourfem ale patients with fistulizing Crohn s disease treated with Inflixim ab . H ealing was com plete, without recurrence. The anti-TNF-α properties of Inflix-im ab suggest that healing m ay be m ediated by the drugs effect on cytokine pathways, perhaps by blunted T cell activation early in the inflam mory cascade .W e ​​suggest an independenteffectofInflixim ab on PG.