scholarly journals Pyoderma Gangrenosum and High Titer Serum Aanti-CCP2 Antibodies

2012 ◽  
Vol 52 (185) ◽  
Author(s):  
S K Das ◽  
N Banerjee ◽  
S Khaskil ◽  
S S Mukherjee
Keyword(s):  
Pyoderma Gangrenosum ◽  
High Titer ◽  
Laboratory Finding ◽  
Skin Grafting ◽  
Neutrophilic Dermatosis ◽  
Split Skin Grafting ◽  
History Of ◽  
Inflammatory Bowel ◽  
The Right ◽  
Split Skin

Pyoderma gangrenosum is an uncommon ulcerative cutaneous neutrophilic dermatosis. In about 50 percent of cases, it is associated with systemic diseases like inflammatory bowel disease, rheumatoid arthritis, systemic lupus erythromatosus, hematological diseases and various malignancies. There is no specific laboratory finding or histological features pathognomonic of pyoderma gangrenosum and it is often a diagnosis of exclusion. Here, we report an elderly female without history of any systemic disorders, presenting to us with extensive, bilaterally symmetrical, deep leg ulcers along with multiple superficial ulcers involving the right groin which was diagnosed as pyoderma gangrenosum. The only positive rheumatologic marker was serum anti-cyclic cittrulinated peptide2 antibody, which was found to be strongly positive. Dramatic response to systemic corticosteroid followed by successful split skin grafting was observed in our patient. Keywords: Anti cyclic cittrulinated peptide2, pyoderma gangrenosum, symmetric leg ulcer.

scholarly journals Introducing a Case of Pyoderma Gangrenosum in the Breast

2020 ◽  
Author(s):  
Mohsen Akhondi Meybodi
Keyword(s):  
Pyoderma Gangrenosum ◽  
Breast Surgery ◽  
Gastrointestinal Symptoms ◽  
Vesicle Formation ◽  
Men And Women ◽  
The Past ◽  
History Of ◽  
Inflammatory Bowel ◽  
Painful Ulcer ◽  
The Right

Introduction: Pyoderma gangrenosum (PG) of the breast is a rare that present as a painful ulcer on the skin. It usually affects people in their 20s to 50s and occurs in both men and women. Typically, PG affects the legs in adults. In children, it may affect the legs, buttocks, head, and neck. Pyoderma gangrenosum is characterized by a papule, nodule, or pustule that progresses to an injured lesion with unknown boundaries. In this study, a case of Pyoderma gangrenosum is introduced after breast surgery. A 38-year-old woman with a 3 cm wound in the right breast area that has gradually grown has been examined for exudative bloody discharge for the past 2 weeks. Two weeks after breast surgery, a three-centimeter progressive wound has formed on the surface of the breast, which gradually grew larger. During treatment, several oral and injectable antibiotics were prescribed that have not been effective in healing the wound. A biopsy lesion was reported in which a non-specific skin lesion with hyperplasia and vesicle formation without malignancy was reported. The patient had no gastrointestinal symptoms. Infliximab was started and continued for the patient. Conclusion: In the differential diagnosis of resistant skin wounds, especially in the leg area, and in this case in the breast the diagnosis of pyoderma gangrenosome should always be considered. Even if the patient has no history of inflammatory bowel disease, pyoderma gangrenosum may occur before intestinal manifestations.

scholarly journals Winning the Battle after Three Years of Suffering: A Case of a Refractory Pyoderma Gangrenosum Treatment Challenge

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Isra Ibrahim ◽  
Hammam Shereef ◽  
Ahmed Hashim ◽  
Heba Habbal ◽  
Raai Mahmood ◽  
...  
Keyword(s):  
Pyoderma Gangrenosum ◽  
Lupus Erythematosus ◽  
Ivig Therapy ◽  
Inflammatory Disorder ◽  
Therapeutic Challenge ◽  
Hematological Disorders ◽  
Bowel Diseases ◽  
History Of ◽  
Inflammatory Bowel ◽  
The Right

Pyoderma gangrenosum is an uncommon inflammatory disorder characterized by neutrophilic infiltration of the skin. It can present as skin papules or pustules that progress into painful ulcers. 30–40% of the cases are associated with other systemic diseases such as inflammatory bowel diseases, rheumatoid arthritis, and proliferative hematological disorders. Uniquely, this condition has been associated with systemic lupus erythematosus (SLE). The rarity of this disorder poses a diagnostic and therapeutic challenge. We present a case of a 55-year-old female with a history of SLE and chronic right leg ulcer, presented with increased pain from the ulcer associated with a mild flare of her cutaneous lupus; examination revealed circumferential skin ulcer measuring about 25 cm extending around the right leg above the ankle with prominent fibrinous material and surrounding erythema. Blood work showed elevated WBC with neutrophilic predominance. Serology revealed a positive ANA, elevated RNP, smith, and SSA/Ro antibodies with normal anti-CCP level. Skin biopsy was taken, and it showed a diffuse neutrophilic and lymphocytic infiltrate consistent with the diagnosis of pyoderma gangrenosum. The patient was then treated with topical and systemic steroids and sequentially with dapsone, methotrexate, mycophenolate, and cyclosporine for over a two-year period but failed to show any improvement. Therefore, a trial of intravenous immunoglobulin (IVIG) therapy was attempted and produced a dramatic response after two-month infusions characterized by shrinking in the size of the ulcer and resolving pain. We believe that refractory PG poses a therapeutic challenge, and despite a lack of specific guidelines, IVIG can be attempted if initial suppressive treatment fails to show signs of improvement.

scholarly journals The vascular armamentarium explored-the ultimate goal achieved

2020 ◽  
Vol 7 (5) ◽  
pp. 1637
Author(s):  
Manoj Prabakar Ravichandran ◽  
Subrammaniyan Rathinavelpandian ◽  
Marunraj Gnanasekaran ◽  
Saravanan Balachandran
Keyword(s):  
Skin Grafting ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Vascular Surgeon ◽  
Interventional Radiological Procedure ◽  
Catheter Directed Thrombolysis ◽  
Split Skin Grafting ◽  
Peripheral Arterial ◽  
The Right ◽  
Split Skin

Peripheral arterial disease is one of the commonest causes for a limb being amputated most often, we present this case of medium vessel vasculitis with chronic threatening limb ischemia to make a note of our attempt to save her limb by multiple modalities which included medical management with steroids, immunosuppressants, pulsed cyclophosphamide, interventional radiological procedure of catheter directed thrombolysis with urokinase, surgical procedures like bypass, split skin grafting and minor amputations, implemented novel modalities like hyperbaric oxygen therapy. By exploring the armamentarium available, involving a multidisciplinary team which included vascular surgeon, rheumatologist, intervention radiologist, plastic surgeon, physiotherapist and aptly using the right modality at the right time we were able to ultimately achieve our goal of limb salvage.

scholarly journals Rescue of diabetic foot from amputation – a case report

2019 ◽  
Vol 65 (3) ◽  
Author(s):  
Andrzej Żyluk ◽  
Wojciech Jagielski
Keyword(s):  
Skin Grafting ◽  
Lateral Ankle ◽  
Incision And Drainage ◽  
Metatarsal Bones ◽  
Split Skin Grafting ◽  
History Of ◽  
Insulin Dependent ◽  
Split Skin ◽  
Tissue Defects

This study presents the case of a 52-year-old man with a 15-year history of insulin-dependent diabetes, who developed phlegmon of his right foot following an attempt to remove a corn. On admission, the patient presented symptoms of incipient sepsis. The treatment – wide incisions on the foot, evacuation of collected pus and necrotic debris, as well as antibiotic therapy – allowed for stabilization of the patient’s general condition. However, the local infection of the foot did not withdraw and the patient required repeated surgeries, including amputation of the toes and metatarsal bones. The infection progressed, spreading to the lateral ankle and the distal part of the calf. During the next operation, following incision and drainage of pus, the substance Stimulan, which aids in the liberation of antibiotics, was introduced to the wounds; this appeared to be effective and resulted in control of the infection. Soft tissue defects were repaired by local flapplasty and split skin grafting. At the follow-up examination 6 months later, the patient displayed completely healed wounds, wore normal shoe on the affected foot, and walked without any support.

scholarly journals 500 Tetraminos Flap

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
T Schrire ◽  
A Din ◽  
U Khan
Keyword(s):  
Skin Graft ◽  
Free Flap ◽  
Femoral Condyle ◽  
Computer Game ◽  
Skin Grafting ◽  
Free Flaps ◽  
Soft Tissue Defect ◽  
Split Skin Grafting ◽  
The Right ◽  
Split Skin

Abstract 30 year old male, who had been hit at 90mph whilst on a motorbike sustaining femoral, tibial and right foot open fractures. He underwent an open reduction and internal fixation (ORIF) of his right lateral femoral condyle, a right retrograde femoral nail, and ORIF of the tibia. He had 2 separate free flaps (a chimera scapular/parascapular and antero-lateral thigh-ALT) to his right lower leg, and split skin grafting to the remainder of the right lower limb. Upon regular post-operative review it was found that whilst healed the limb was showing a poor return of function and a major contributor was the lack of motion of the right knee joint. Patient had an excision of the split skin graft, with a quadriceps plasty, where the myofascial planes were released, and the contractures incised, with a chimeric scapular and parascapular free flap onto the defect. This resulted in coverage of large soft tissue defect with no need to skin graft donor sites and no functional implication of muscle harvest. Tetraminos in appearance, like the popular computer game, which has never before been described, compared with normal coverage, which would be latissimus dorsi free flap and graft.

MANAGEMENT OF POST BURN CONTRACTURE OF NECK IN A TERTIARY BURN CARE CENTRE

2021 ◽  
pp. 33-35
Author(s):  
Nangineedi Nagaprasad ◽  
Karthik G B
Keyword(s):  
Surgical Planning ◽  
Skin Grafting ◽  
Burn Care ◽  
Split Skin Grafting ◽  
Contracture Release ◽  
Common Problems ◽  
A Prospective Study ◽  
Split Skin ◽  
Burn Contractures

Background: Post burn contracture is one of the most common problems in our country and usually seen in lower socio-economic people. Burn contractures of the neck can produce a signicant impact on quality of life by reducing a patient's ability to perform activities of daily living Methods: A prospective study was conducted with a sample size of 30 patients with post burn neck contracture conducted for a duration of 24 months. After meticulous surgical planning, patients underwent contracture release and split skin grafting/z-plasty followed by rigorous splintage and physiotherapy. Majority of the patients were in the age group of 11-30 years (63%).70% of the Results: patients sustained burns in the range of 21-40% and 80% were due to ame burns.46.66% (14) of patients had severe contracture while 13.33% (4) had extensive mento-sternal adhesions. 90% of the patients underwent release + SSG while 10% underwent z-plasty. Postoperatively cervico-mental angle of 100-120 degrees was achieved Skin grafting is a simple, reliable and safe operation however postoperative splinting is n Conclusion: ecessary. The use of skin grafts continues to deliver excellent results with adequate restoration of cervico-mental angle.

scholarly journals Ulcerative Colitis and Sweet’s Syndrome: A Case Report and Review of the Literature

2008 ◽  
Vol 22 (3) ◽  
pp. 296-298 ◽  
Author(s):  
Massud Ali ◽  
Donald R Duerksen
Keyword(s):  
Ulcerative Colitis ◽  
Immunosuppressive Therapy ◽  
Neutrophilic Dermatosis ◽  
Sweet’S Syndrome ◽  
Review Of The Literature ◽  
Neutrophilic Infiltration ◽  
Drug Induced ◽  
Sweet's Syndrome ◽  
History Of ◽  
Inflammatory Bowel

A 47-year-old man with a history of ulcerative colitis on prednisone and azathioprine was admitted to the hospital with a four-day history of fever, skin rash, arthralgias and leukocytosis. A skin biopsy demonstrated neutrophilic infiltration of the dermis that was consistent with Sweet’s syndrome. He improved after several days with an increase in his prednisone and azathioprine. Sweet’s syndrome is a rare cutaneous manifestation of inflammatory bowel disease, with approximately 40 cases reported in the literature. In a previously reported case of a patient with ulcerative colitis-associated Sweet’s syndrome who was on azathioprine at the time of the skin eruption, the azathioprine was stopped, raising the possibility of drug-induced Sweet’s syndrome. In the present case, the azathioprine was actually increased with complete resolution of the skin manifestations. This would support the theory that immunosuppressive therapy is the mainstay of therapy for this condition. In conclusion, Sweet’s syndrome is a neutrophilic dermatosis that is rarely associated with ulcerative colitis. It may occur while on immunosuppressive therapy and responds to an intensification of immunosuppression.

Split Skin Grafting

2016 ◽  
pp. 107-128
Author(s):  
Aziz Nather ◽  
Ting Fang Tan
Keyword(s):  
Skin Grafting ◽  
Split Skin Grafting ◽  
Split Skin
Sign in / Sign up

Export Citation Format

Share Document