Pyoderma gangrenosum after reduction mammoplasty: diagnostic and therapeutic challenges

Author(s):  
Igor Nagai Yamaki ◽  
Celso Jandre Boechat ◽  
Rodrigo Carlleti Rizzo ◽  
Stella Souza Amorim ◽  
Gabriela Figueira Andrade ◽  
...  
2021 ◽  
Vol 33 (7) ◽  
pp. E58-E60
Author(s):  
Gunel Guliyeva ◽  
Ali Kilic

Introduction. Pyoderma gangrenosum (PG) is a multifactorial neutrophilic dermatosis of unknown etiology. It can occur in isolation; in association with different inflammatory, autoimmune, or malignant diseases; or as part of various syndromes. Because of its low incidence and the difficulty in distinguishing it from other possible lesions, PG is usually misdiagnosed. As a result, patients may be subjected to unnecessary treatments and surgical interventions that exacerbate the development of PG, as pathergy phenomenon is observed with this skin disorder. Surgical trauma can also lead to the formation of PG with the same mechanism. The occurrence of PG lesions has been reported after plastic surgery as well. In most cases, however, the diagnosis is delayed, resulting in disfigurement, additional surgeries, and extended hospital stay. Case Report. In this article, a case of early detected bilateral PG after reduction mammoplasty in a patient with no personal or family history of autoimmune disorders is presented. Careful examination of the wound and analysis of the clinical picture resulted in the diagnosis of PG. Conclusions. The authors believe that the description of the diagnostic clues considered in this case will aid the plastic surgeon in prompt recognition and management of postoperative PG, with the aim of decreasing patient morbidity and the duration of hospital stay while preventing additional complications.


2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Sara Tanini ◽  
Gianmarco Calugi ◽  
Giulia Lo Russo

Pyoderma gangrenosum (PG) is a rare non-infective inflammatory disease of unknown etiology characterized by cutaneous papulo-pustoles that rapidly evolve into painful ulcerative lesions. Postoperative PG (PPG) is a clinical variant of PG in which pathergic response occurs at surgical sites. It is important to include PG in the differential diagnosis of breast ulceration. An incorrect diagnosis and treatment can potentially worsen the patient state, causing disfigurement with extensive scarring, an unpleasant aesthetic result and produce consequent psychological trauma. We report a case of PPG after bilateral breast reduction mammoplasty treated with negative pressure wound therapy (NPWT) as local treatment for wound dehiscence in combination with systemic steroid therapy. This synergism led to a good aesthetic result. NPWT improved wound perfusion, it decreased the exudate, and promoted adherence of the mammary gland to the pectoral muscle. After 31 days deep sutures were placed to directly close the wound and the patient was discharged. PPG is a rare, devastating occurrence after surgery. Surgeons must know that PPG is an evenience that can occur in otherwise healthy patients and must be considered in the differential diagnosis in case of necrotic ulcers and apparent infection status. NPWT resulted to have benefits in the treatment of PPG, with a role in limiting the size of the defect, avoiding pathergic self-reaction and allowing a faster recovery with higher chances of achieving a better result.


2019 ◽  
Author(s):  
BIANCA ALENCAR DIAS ALMEIDA ◽  
RITA MARINA SOARES DE CASTRO DUARTE ◽  
ERNANI COELHO ALENCAR ◽  
EDSON MOREIRA BATISTA ◽  
JANDIR MENDONÇA NICACIO ◽  
...  

Author(s):  
Igor Nagai Yamaki ◽  
Celso Jandre Boechat ◽  
Rodrigo Carlleti Rizzo ◽  
Stella Souza Amorim ◽  
Gabriela Figueira Andrade ◽  
...  

1996 ◽  
Vol 21 (2) ◽  
pp. 151-153
Author(s):  
M. SHAH ◽  
F.M. LEWIS ◽  
C.I. HARRINGTON
Keyword(s):  

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