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Case Report

Combined Dopaminergic Drugs to Treat Pyoderma Gangrenosum

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Open Access
Article Type Case Report
Subject Medicine Group
OCLC JBRES Record
Jerome H Check* and Diane L Check
Issue: Volume7-Issue3
Pages: 1-8
Received: 2026-03-21
Accepted: 2026-03-30
Published: 2026-03-31

Abstract

Monoclonal antibody therapy directed against certain pathways leading to the eventual cellular immune reaction to an irritating agent has been a mainstay of therapy for many pathological conditions considered autoimmune in nature. Unfortunately, these monoclonal antibody therapies are extremely expensive, and may lead to some serious adverse complication e.g., risk of infection or developing cancer based on generalized immune suppression, and other less common adverse effects that may be quickly lethal. Some of these autoimmune conditions may over time show a greater frequency of other types of autoimmune pathology. For example, patients with rheumatoid arthritis and inflammatory bowel disease may develop subsequently certain autoimmune skin disorders e.g., pyoderma gangrenosum. Interestingly dopamine agonists have been found to very effectively ameliorate rheumatoid arthritis, inflammatory bowel disease, and many autoimmune skin disorders that previously failed to respond adequately to these other biological immunosuppressants A case of a 51-year-old woman with a long history of rheumatoid arthritis had failed to respond adequately to immune suppression with high dosage, glucocorticoids and could not tolerate either Etanercept or Adalimumab. However, for many years, her joint pain and fatigue were markedly improved following treatment with the dopamine agonist dextroamphetamine sulfate. After many years on dextroamphetamine, she developed pyoderma gangrenosum, which not only failed to improve despite two courses of infliximab, unfortunately she had a very severe reaction to the drug. She did have marked improvement, however, with the addition of another dopamine agonist carbidopa levodopa. The hypothesized mechanism of action of dopamine agonists is to correct tissue permeability defects, thus inhibiting irritating agents from crossing the mucosal barrier leading to severe inflammation.

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© 2026 Check JH, et al. Distributed under Creative Commons CC-BY 4.0 Creative CommonsAttribution

How to cite this article

Check JH, Check DL. Combined Dopaminergic Drugs to Treat Pyoderma Gangrenosum. J Biomed Res Environ Sci. 2026 Mar 31; 7(3): 8. Doi: 10.37872/jbres2286

Subject area(s)

ImmunologyTherapeuticsPharmacologyDermatology

References

  1. Maronese CA, Pimentel MA, Li MM, Genovese G, Ortega-Loayza AG, Marzano AV. Pyoderma Gangrenosum: An Updated Literature Review on Established and Emerging Pharmacological Treatments. Am J Clin Dermatol. 2022 Sep;23(5):615-634. doi: 10.1007/s40257-022-00699-8. Epub 2022 May 24. PMID: 35606650; PMCID: PMC9464730.
  2. Marzano AV, Borghi A, Meroni PL, Cugno M. Pyoderma gangrenosum and its syndromic forms: evidence for a link with autoinflammation. Br J Dermatol. 2016 Nov;175(5):882-891. doi: 10.1111/bjd.14691. Epub 2016 Aug 23. PMID: 27106250.
  3. Vacas AS, Torre AC, Bollea-Garlatti ML, Warley F, Galimberti RL. Pyoderma gangrenosum: clinical characteristics, associated diseases, and responses to treatment in a retrospective cohort study of 31 patients. Int J Dermatol. 2017 Apr;56(4):386-391. doi: 10.1111/ijd.13591. PMID: 28295267.
  4. Ruocco E, Sangiuliano S, Gravina AG, Miranda A, Nicoletti G. Pyoderma gangrenosum: an updated review. J Eur Acad Dermatol Venereol. 2009 Sep;23(9):1008-17. doi: 10.1111/j.1468-3083.2009.03199.x. Epub 2009 Mar 11. PMID: 19470075.
  5. Maverakis E, Marzano AV, Le ST, Callen JP, Brüggen MC, Guenova E, Dissemond J, Shinkai K, Langan SM. Pyoderma gangrenosum. Nat Rev Dis Primers. 2020 Oct 8;6(1):81. doi: 10.1038/s41572-020-0213-x. PMID: 33033263.
  6. Check JH, Gentlesk MJ, Falanga V. Sympathomimetic amines in the treatment of chronic urticaria: two case reports. Cutis. 1984 Oct;34(4):388-90. PMID: 6488891.
  7. Check JH, Amadi C, Kaplan H, Katsoff D. The treatment of idiopathic edema, a cause of chronic pelvic pain in women: effectively controlled chronic refractory urticaria--case reports. Clin Exp Obstet Gynecol. 2006;33(3):183-4. PMID: 17089586.
  8. Check JH, Cohen R, Check D. Idiopathic edema, a condition associated with pelvic pain and other symptoms in women, as a remedial cause of chronic cold induced urticaria. Clin Exp Obstet Gynecol. 2010;37(3):235-6. PMID: 21077535.
  9. Check JH, Dougherty MP. Use of sympathomimetic amines to correct premenstrual urticaria and anaphylaxis. Clin Exp Obstet Gynecol. 2019;46:309-312.
  10. Check JH, Chan S. Complete eradication of chronic long standing eczema and keratosis pilaris following treatment with dextroamphetamine sulfate. Clin Exp Obstet Gynecol. 2014;41(2):202-4. PMID: 24779252.
  11. Check JH, Neumann BA, Check DL. The use of dopaminergic drugs for treating cutaneous discoid lupus erythematosus: a case study. J Med Clin Res & Rev. 2024;8(3):1-3.
  12. Check JH, Neumann BA, Check DL. Dopaminergic drugs for the successful treatment of bullous pemphigoid (BP). J Med Clin Res & Rev. 2024;8(3):1-3.
  13. Torikashvili JJ, Check JH, McDonald O’Neil M, Neulander M. A Case Presenting a Novel Treatment of Palmoplantar Eczema: Dopaminergic Drugs, International Journal of Clinical Case Reports and Reviews. 2025;22(2). doi: 10.31579/2690-4861/631
  14. Check JH. A second case of palmoplantar eczema effectively ameliorated following treatment with the dopamine agonist dextroamphetamine sulfate. Int J Clin Med Case Stud. 2025;2(2):1033.
  15. Lombardi G, Check JH. A novel effective therapy for chronic generalized pruritus without presence of skin lesions. J Med Clin Res & Rev. 2024;8(5):1-4.
  16. Check JH, Cohen R. Amelioration of severe generalized idiopathic pruritus in an estrogen deficient woman taking an aromatase inhibitor for breast cancer following treatment with amphetamine salts. Clin Exp Obstet Gynecol. 2017;44:934-935.
  17. Check JH, Nkewnkwa NG, Srivastava P. The Dopamine Agonist Dextroamphetamine Sulfate as A Highly Effective Therapy for Dystrophic Epidermolysis Bullosa, Clinical Case Reports and Studies, BioRes Scientia Publishers. 2026;12(2):1-7. doi: 10.59657/2837-2565.brs.26.299
  18. Check JH, Check DL. Dopamine agonist therapy to treat erythromelalgia- Case Report. Clinical Case Reports and Studies, BioRes Scientia Publishers. 2026;12(2):1-6. doi: 10.59657/2837-2565.brs.26.310
  19. Present SI, Check JH. Hypofunction of the Sympathetic Nervous System as a Possible Etiologic Cause of Recurrent Aphthous Stomatitis. Compend Contin Educ Dent. 2016 Jun;37(6):381-385;quiz386. PMID: 27517475.
  20. Check JH, Ganpo Nkwenkwa N. Strong multi-sibling presence of manifestations of the condition called the increased cellular permeability syndrome without paternal presence adds confusion to the mechanism of inheritance in polygenic disorders. Int J Clin Med Case Stud. 2025;2(1):1021.
  21. Check JH, Cohen R, Katsoff B, Check D. Hypofunction of the sympathetic nervous system is an etiologic factor for a wide variety of chronic treatment-refractory pathologic disorders which all respond to therapy with sympathomimetic amines. Med Hypotheses. 2011 Nov;77(5):717-25. doi: 10.1016/j.mehy.2011.07.024. Epub 2011 Aug 10. PMID: 21835553.
  22. Check JH. Changing the name of a syndrome: Sympathetic neural hyperalgesia edema syndrome becomes – the increased cellular permeability syndrome. Clin Exp Obstet Gynecol. 2017;44:819-823.
  23. Check DL, Check JH. Various presentations of the increased cellular permeability syndrome in males responding very well to sympathomimetic amine therapy – possible treatment for end-stage Covid-19 complications. J Med Clin Res & Rev. 2020;4(7):1-7.
  24. Check JH. Most chronic conditions in women are related to increased cellular permeability and most can be effectively treated with dopaminergic drugs. J Biomed Res Environ Sci. 2024;5(4):373-386.
  25. Check JH, Nazari P, Goldberg J, Yuen W, Angotti D. A model for potential tumor immunotherapy based on knowledge of immune mechanisms responsible for spontaneous abortion. Med Hypotheses. 2001 Sep;57(3):337-43. doi: 10.1054/mehy.2001.1333. PMID: 11516226.
  26. Check JH. Studies of Mechanisms Involved in Successful Embryo Implantation Has Led to Novel Highly Effective Treatments for a Plethora of Chronic Illnesses and Advanced Cancer. Am J Biomed Sci & Res. 2025;25(4). doi: 10.34297/AJBSR.2025.25.003349
  27. Check JH, Aly J, Chang E. Improving the chance of successful implantation - part I - embryo attachment to the endometrium and adequate trophoblast invasion. Clin Exp Obstet Gynecol. 2016;43(6):787-791. PMID: 29944223.
  28. Check DL, Check JH. Novel methods of improving fecundity and various pathological disorders based on a hypothetical model of embryo implantation. Gynecol Reprod Health. 2020;4(4):1-15
  29. Check JH, Cohen R. The triad of luteal phase ocular migraines, interstitial cystitis, and dyspareunia as a result of sympathetic nervous system hypofunction. Clin Exp Obstet Gynecol. 2014;41(5):575-7. PMID: 25864263.
  30. Check JH. Increased tissue permeability and sympathetic nervous system hypofunction may be the common link between dysmenorrhea, chronic pelvic pain, Mittelschmerz, and Crohn's disease. Clin Exp Obstet Gynecol. 2016;43(1):112-3. PMID: 27048029.
  31. Check JH. Increased Cellular Permeability Related to Relative Dopamine Deficiency May Play a Major Role in the Etiology of Dyspareunia by Causing Inflammation. J Sex Health Reprod Med. 2025;1(1):1-7. doi: 10.61440/JSHRM.2025.v1.02
  32. Check JH, Carpenteier P, Meier B, Ganpo-Nkewnkwa N. Dopaminergic drug very effective for relieving pelvic pain in women even when hormonal therapy and surgery were not sufficient. J Sex Health Reprod Med. 2025;1(3):1-4.
  33. Boimel P, Check JH. Marked improvement of intractable arthritic pain in a woman with rheumatoid arthritis with sympathomimetic amine treatment despite previous failure with standard therapy and possible implications for last trimester unexplained fetal demise--case report. Clin Exp Obstet Gynecol. 2007;34(4):254-6. PMID: 18225693.
  34. Check JH, Cohen R. Marked improvement of pain from long-term fibromyalgia with dextroamphetamine sulfate in a woman who failed to improve with conventional pharmacologic treatment. Clin Exp Obstet Gynecol. 2014;41(1):90-2. PMID: 24707694.
  35. Check JH, Cohen R. Sympathomimetic amine therapy found effective for treatment of refractory chronic complex regional pain syndrome (reflex sympathetic dystrophy). Clin Exp Obstet Gynecol. 2014;41(4):478-82. PMID: 25134306.
  36. Check JH, Check DL, Dougherty MP. Marked improvement of the aromatase induced arthralgia syndrome following treatment with dextroamphetamine sulfate. Clin Exp Obstet Gynecol. 2019;46:291-292.
  37. Check JH, Check DL. A novel therapy for polymyalgia rheumatica dopaminergic drugs. Herculean Res. 2024;1(2):11-14.
  38. Check JH, Lombardi G, Janvier J. Two new clinical manifestations of the increased cellular permeability syndrome responding well to dopaminergic drugs; carpel tunnel syndrome, and sesamoiditis. Bio Med Res J. 2024;8(3):814-818.
  39. Check JH, Cohen R. Sympathetic neural hyperalgesia edema syndrome, a frequent cause of pelvic pain in women, mistaken for Lyme disease with chronic fatigue. Clin Exp Obstet Gynecol. 2011;38(4):412-3. PMID: 22268288.
  40. Check DL, Check JH, Katsoff B. Dextroamphetamine sulfate therapy markedly improves the chronic fatigue syndrome. J Nurs Occup Health. 2020;2(3):146-148.
  41. Check DL, Check JH, Citerone T, Cremin N. Sympathomimetic amine therapy markedly improves severe fatigue that diminishes quality of life in patients with cancer – A case report. Cancer Sci Res. 2020;3(3):1-3.
  42. Check JH, Cohen R. Marked improvement of severe gastroparesis following high dosage, but very well tolerated, dextroamphetamine sulfate. Clin Exp Obstet Gynecol. 2017;44:611-612.
  43. Check JH, Neumann B, Check DL. Dopaminergic drugs to relieve pain from chronic pancreatitis – a novel therapy. J Med Clin Res Rev. 2024;8(1):1-4.
  44. Check JH, McDonald O’Neil M, Neulander M, Check DL. Dopaminergic drug Combination for Stomatodynia Eliminates Tardive Dyskinesia Resulting from Higher Dosages of Dextroamphetamine, J Clinical Research and Reports. 2025;18(3). doi: 10.31579/2690-1919/436
  45. Check JH, Srivastava P, Kelley C. The relative efficacy of three different dopamine agonists in relieving symptoms of various manifestations of the increased cellular permeability syndrome. Case report. Int J Clin Med Case Stud. 2025;2(2):1039.
  46. Check JH, Check DL, Dougherty MP. Progesterone receptor antagonists – a novel treatment for severe hyponatremia from the endocrine paraneoplastic syndrome. J Endocrinol Res. 2021;3:40-43.
  47. Check JH. A follicle stimulating hormone (FSH) receptor up-regulation technique as a method for follicular recruitment for in vitro fertilization-embryo transfer in women with diminished oocyte review. Ed. Leon V. Berhardt; In: Advances in Medicine and Biology, Nova Science Publishers, Inc., Hauppauge, NY, 2022, vol. 195, chapter 4, 119-137.
  48. Check JH, Neumann B. Combined Dopaminergic Drugs with Supplemental Progesterone to Treat Recurrent Miscarriage and Ulcerative Colitis despite Diminished Egg Reserve. Gynecol Reprod Health. 2024;8(2):1-10.
  49. Check JH, Check DL, Neumann B. A Novel Treatment of Crohn’s Disease that is Not Only Safe in Pregnancy but Can Correct Infertility and Recurrent Miscarriages. Gynecol Reprod Health. 2024;8(2):1-9.
  50. Check JH, Cohen R. Sympathomimetic amine therapy abrogates severe long-term unexplained abdominal pain and diarrhea (microscopic colitis) – possible infertility implications. Clin Exp Obstet Gynecol. 2019;46:489-491.
  51. Weidner J, Check JH. Marked improvement of the autoimmune syndrome associated with autoimmune hepatitis by treatment with sympathomimetic amines. Clin Exp Obstet Gynecol. 2014;41(4):460-1. PMID: 25134299.
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