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This article discusses a case report of a patient who developed peristomal pyoderma gangrenosum (PG) while being treated with TNF-α inhibitors for rheumatoid arthritis (RA) and Behçet's disease (BD). Despite treatment with various medications, the patient's ulcers persisted and worsened. However, when the patient was switched to baricitinib, a Janus kinase (JAK) inhibitor, both the RA and the PG improved. The article suggests that JAK inhibitors may be an alternative treatment option for patients with PG who do not respond to TNF-α inhibitors. [Extracted from the article] more...

Aim: This study aimed to analyze the muscle magnetic resonance imaging (MRI) findings of patients with antineutrophilic cytoplasmic antibody‐associated vasculitis (AAV) and polyarteritis nodosa (PAN) presenting with clinical symptoms in the extremities. Methods: Retrospective analysis was conducted on short tau inversion recovery MRI findings, with a focus on intramuscular vessels displaying abnormal perivascular signals, in 22 and eight patients with AAV and PAN, respectively. The number per unit area (4 cm2) and diameter of abnormal vessels on muscle MRI were compared between patients with AAV and those with PAN. Cut‐off values, clinical sensitivity, and specificity for these indices were calculated from the receiver operating characteristic curves to distinguish between AAV and PAN, and the relationship between the indices and clinical findings in AAV was analyzed. Results: The number of abnormal vessels per unit area was significantly higher in AAV compared to PAN (p <.05). Additionally, the diameter of the abnormal vessels was significantly higher in PAN than in AAV (p <.05). The presence of >6.44 abnormal vessels per unit area or ≤3.61 mm diameter of abnormal vessels was able to predict AAV (sensitivity, 0.955; specificity, 0.625). AAV patients with peripheral neuropathy exhibited a significantly higher number of abnormal vessels per unit area than those without peripheral neuropathy (p <.05). Conclusions: Muscle MRI can detect small‐ to medium‐vessel vasculitis and be a valuable tool for distinguishing between patients with AAV and PAN experiencing clinical symptoms in the extremities. [ABSTRACT FROM AUTHOR] more...