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Rev Med Liege. 2017 May;72(5):227-232.

[Pathergic postsurgical-induced Pyoderma gangrenosum].

[Article in French; Abstract available in French from the publisher]

Author information

1
Faculté de Médecine, Université de Liège, Belgique.
2
Service de Dermatologie, CHU de Liège, Site Sart Tilman, Liège, Belgique.
3
Service d'Anesthésie-Réanimation, Clinique André Renard, Herstal, Belgique.
4
Université de Namur, Belgique.
5
Service de Dermatologie, Hôpital Saint-Louis, Paris, France.
6
Service de Chirurgie Plastique, Esthétique et Reconstructrice, Clinique Saint-Vincent de Rocourt (CHC), Liège, Belgique.

Abstract

in English, French

Pyoderma gangrenosum (PG) is a rare pustular and ulcerative inflammatory disease belonging to the group of neutrophilic dermatoses. It is frequently associated with systemic immune diseases. In this context the PG can be exceptionally triggered by tissue trauma such as surgery (pathergy). We report the case of a patient with stabilized rheumatoid arthritis who developed aggressive and disseminated PG at all surgical wounds following an abdominal dermolipectomy associated with breast pexy. Systemic corticosteroid methylprednisolone allowed a rapid control of skin ulcerations. In the aftermath of an intervention, PG is often confused with a bacterial skin-necrotizing panniculitis. The recognition of the inflammatory nature of cutaneous symptoms is crucial to quickly start an immunosuppressive treatment and limit scarring sequelae. Our case also illustrates the need to consider any history of dysimmune inflammatory or oncohematological disease as a risk factor before surgery, even if the latter are stabilized.

KEYWORDS:

Neutrophilic dermatoses ; Pathergy ; Postoperative infection ; Skin necrosis; Pyoderma gangrenosum

PMID:
28520320
[Indexed for MEDLINE]
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