With the patient’s agreement, we startedInfliximab (INN; trade names Remicade, Remsima, Inflectra) as an off-label treatment at a dosage of 0.5 mg/kg administered IV at 8-week intervals subsequent to the induction phase. After five months, the active lesions were found to have improved. At 10 months, the lesions were observed to have resolved, leaving persistent cicatricial scars and nodules, and the infliximab was discontinued. Three months later, the patient suddenly developed fever, arthromyalgia, and dyspnea, along with the reactivation of HS lesions, and was therefore hospitalized with a diagnosis of sepsis caused by Acinetobacter baumannii. Moreover, an ulcerative lesion developed on the upper right gluteus and enlarged to the size of 10 × 4 cm within five weeks. Histological examination of biopsy material obtained from the edge of the lesion showed a moderately differentiated squamous cell carcinoma (SCC).
Unfortunately, despite systemic antibiotic treatment (colistin IV), the patient died of complications caused by sepsis.Case Study Diagnosis Treatment