Pyoderma gangrenosum is a rare pathology of uncertain etiology. It is an inflammatory dermatosis that causes cutaneous necrosis with a characteristically rapid evolution. No precise diagnosis criteria has been established and pyoderma gangrenosum remains an exclusion diagnosis. In 40 to 50% of the cases, the evolution of pyoderma gangrenosum can be worsened by a nonspecific external stimulus such as a trauma or a surgery. This phenomenon, called pathergy, conduces to avoid any surgical excision of the lesion. However, the diagnosis is often omitted and the rapid evolution of the cutaneous necrosis forces the surgeon to perform a surgical debridement of the wound. It causes a worsening of the lesion. It can have disastrous consequences. We present here three different case reports.
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http://dx.doi.org/10.1016/j.anplas.2008.05.006 | DOI Listing |
Adv Skin Wound Care
January 2025
Arbie Sofia P. Merilleno, MD, DPDS, is an Inflammatory Disease Fellow, University of Toronto, Ontario, Canada; Clinical Fellow, Women's College Hospital, Ontario; and Research Fellow, Women's College Research Institute, Ontario. Charlene Marie Ang-Tiu, MD, FPDS, is Medical Specialist, Rizal Medical Center, Pasig City, Philippines.
Pyoderma gangrenosum is a rare ulcerative condition that poses diagnostic and therapeutic challenges. Diagnosis and appropriate management are often delayed due to its rarity and the presence of numerous clinical variants. In this case report, the authors present the case of a 36-year-old man who had long-standing and nonhealing ulcers that did not respond to multiple antibiotics and serial wound debridement.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Dermatology Department, Cliniques universitaires Saint-Luc, Brussels, Belgium
We describe a man in his 60s presenting poor scar development following surgical treatment for popliteal aneurysm. The clinical features in a postoperative context and the poor clinical response to intravenous broad-spectrum antibiotics were highly suggestive of bullous pyoderma gangrenosum. Histology, with dense inflammatory infiltrate of neutrophils, subsequently confirmed the diagnosis and the response to systemic corticosteroids was rapid and complete.
View Article and Find Full Text PDFReumatologia
December 2024
Department of Internal Medicine, Trofa Saúde Hospital Privado em Gaia, Vila Nova de Gaia, Portugal.
Autoinflammatory bone disorders (ABDs) are characterized by sterile bone inflammation stemming from dysregulated innate immune responses. This review focuses on the occurrence of sterile osteomyelitis in ABDs and related diseases, notably chronic nonbacterial osteomyelitis (CNO) and its sporadic and monogenic forms, such as deficiency of the interleukin-1 (IL-1) receptor antagonist, Majeed syndrome, CNO related to mutation, and pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA syndrome). Additionally, other autoinflammatory disorders (AIDs) are discussed, including classical periodic fever syndromes (e.
View Article and Find Full Text PDFAn Bras Dermatol
January 2025
Department of Dermatology, Hospital de Câncer de Barretos, Barretos, SP, Brazil; Department of Dermatology, Faculdade de Ciências da Saúde de Barretos Dr. Paulo Prata, Barretos, SP, Brazil.
An Bras Dermatol
January 2025
Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil. Electronic address:
Ischemic ulcers due to compromised microcirculation of the lower limbs cause painful ulcers that pose a challenge for the correct diagnosis and treatment. Livedoid vasculopathy, calciphylaxis, and Martorell's hypertensive ischemic ulcer are part of this group and present some similarities due to microvascular occlusive impairment. They are often misdiagnosed as inflammatory ulcers such as pyoderma gangrenosum and vasculitis.
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