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While its aetiology is often unclear, up to half of cases associate with systemic inflammatory disease. A 65-year-old woman used Melanotan and developed ulcerated wounds at injection sites on her abdomen, with erythematous edges matching the melanotan sites. PG diagnosis followed characteristic appearance, progression, poor antibiotic response, and negative bacteriology. Treatment with topical betamethasone, steroid occlusion, and titrated prednisolone led to healing with cribriform scars. Drug-induced PG is rarely reported, and melanotan-induced PG had not been previously described.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/pyoderma-gangrenosum-secondary-to-melanotan-drug-induced-case-report/412911/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/pyoderma-gangrenosum-secondary-to-melanotan-drug-induced-case-report/412911.png","ImageObject",300,407,{"name":92,"@type":93},"awa","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-01","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why was pyoderma gangrenosum diagnosed in this case?","Question",{"text":112,"@type":113},"Diagnosis relied on the wounds’ characteristic appearance, rapid progression, lack of improvement with multiple antibiotics, and negative bacteriology including tests for Panton-Valentine leukocidin Staphylococcus aureus.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What role did Melanotan play in the patient’s disease?",{"text":117,"@type":113},"The woman reported using Melanotan prior to developing ulcerated lesions at the injection sites, indicating a drug-associated trigger. The article notes melanotan-induced PG had not been reported previously.",{"name":119,"@type":110,"acceptedAnswer":120},"What treatments were used and what was the outcome?",{"text":121,"@type":113},"The patient started topical betamethasone with steroid occlusion tape and oral prednisolone, then topical therapy with Dermovate. The wounds healed over several months, leaving classic cribriform scars.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},412911,1790814842,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},3985747858093,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Open Access Case Report  \nPyoderma Gangrenosum Secondary to Melanotan  \nDaniel Dickson 1, Su Hlaing Htwe 1  \nReview began 11/20/2025  \nReview ended 11/28/2025  \nPublished 12/02/2025  \n© Copyright 2025  \nDickson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98297  \n1. Dermatology, Glasgow Royal Infirmary, Glasgow, GBR Corresponding author: Daniel Dickson, [daniel.dickson2@nhs.scot](daniel.dickson2@nhs.scot)  \nAbstract  \nPyoderma gangreonsum (PG) is a rare neutrophilic dermatosis that presents as a rapidly enlarging ulcer. Although the exact aetiology is unclear, up to half of the cases are linked to a systemic inflammatory disorder such as rheumatological conditions, haematology malignancy, or inflammatory bowel disease. A 65-year-old woman reported utilising Melanotan and subsequently developing ulcerated wounds at the injection sites on her abdomen. Clinically, four wounds were noted with an erythematous edge corresponding to the injection sites of melanotan. A diagnosis of PG was obtained due to the wounds’appearance, progression rate, lack of response to multiple courses of antibiotics, and negative bacteriology, including Panton-Valentine leukocidin Staphylococcus aureus. Topical betamethasone, alongside steroid occlusion tape and prednisolone, was commenced with good effect. Prednisolone was slowly titrated, and topical therapy with Dermovate was initiated. The wounds healed with classic cribriform scars after several months of treatment. Drug-induced PG has rarely been documented. However, melanotan-induced PG has never been reported in the literature before. We hope to highlight this case to increase awareness of the side effects of melanotan.  \nCategories: Dermatology  \nKeywords: diagnosis and treatment of pyoderma gangrenosum, drug-induced pyoderma gangrenosum, melanotan, superficial pyoderma gangrenosum, ulcerative pyoderma gangrenosum  \nIntroduction  \nMelanotan is a synthetic analogue of the peptide alpha melanocyte-stimulating hormone, which stimulates the melanocortin type 1 receptor to stimulate melanogenesis and cause tanning [1] . Secondary effects include increased libido and penile erections. Melanotan has been popularised on social media as a beauty product and can be purchased online easily, either as a subcutaneous injection or a nasal spray. The use of it is currently unregulated, and side effects such as priapism and architectural changes of nevi have been reported previously [2] .  \nTypically, pyoderma gangrenosum (PG) is associated with systemic inflammatory disorders such as inflammatory bowel disease, rheumatoid arthritis, and haematological malignancies. Very rarely, it can be drug-induced, and reported culprits include isotretinoin, tyrosine kinase inhibitors, and cocaine [3] . PG can exist as an ulcerative or classic subtype, which begins as small pustules and rapidly ulcerate into painful lesions with violaceous borders, vegetative PG with superficial ulcers lacking a violaceous border, bullous PG with painful, rapidly spreading superficial bullae with inflamed blue grey borders, or peristomal PG in which lesions occur near stoma sites [3,4] .  \nPyoderma is considered a neutrophilic inflammatory disease. Diagnosis is usually made clinically by the classic appearance and exclusion of other causes. Pathology demonstrates dermal infiltration of mature neutrophils and evidence of necrosis and haemorrhage at the base of the lesions [1] . Management consists of both potent topical steroids, wound care, and, in severe cases, systemic therapy with oral corticosteroids or cyclosporine and mycophenolate mofetil. Case reports exist of tumour necrosis factor-alpha inhibitors such as adalimumab and infliximab being utilised with good effect have also been reported with some effic","cbCaicoPjIlKf8Mt","https://ap.wps.com/l/cbCaicoPjIlKf8Mt","pdf",2914052,"English","# Abstract\n# Introduction\n# Case Presentation\n# How to cite this article","[{\"question\":\"Why was pyoderma gangrenosum diagnosed in this case?\",\"answer\":\"Diagnosis relied on the wounds’ characteristic appearance, rapid progression, lack of improvement with multiple antibiotics, and negative bacteriology including tests for Panton-Valentine leukocidin Staphylococcus aureus.\"},{\"question\":\"What role did Melanotan play in the patient’s disease?\",\"answer\":\"The woman reported using Melanotan prior to developing ulcerated lesions at the injection sites, indicating a drug-associated trigger. The article notes melanotan-induced PG had not been reported previously.\"},{\"question\":\"What treatments were used and what was the outcome?\",\"answer\":\"The patient started topical betamethasone with steroid occlusion tape and oral prednisolone, then topical therapy with Dermovate. The wounds healed over several months, leaving classic cribriform scars.\"}]","Pyoderma Gangrenosum Secondary to Melanotan - Drug-induced case report | PDF",1790593187,13]