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Unfallchirurg. 2019 Aug 7. doi: 10.1007/s00113-019-00704-6. [Epub ahead of print]

[Complex treatment of pyoderma gangrenosum after minor trauma and primary surgical intervention with suspected necrotizing fasciitis].

[Article in German]

Author information

1
Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland. Alexander.Hofmann@medizin.uni-leipzig.de.
2
Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Leipzig, Deutschland.
3
Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland.

Abstract

This article presents the case of a rapidly progressing pyoderma gangrenosum (PG) following a minor trauma and surgical intervention. A 46-year-old patient was admitted to hospital after a minor trauma of the right lower leg with a suspected diagnosis of erysipelas bullosum. A magnetic resonance imaging (MRI) scan showed the suspicion of necrotizing fasciitis (NF) with indications for immediate incision and fascia resection. According to the results of the histopathological analysis and microbiological assessment without signs for a bacterial infection, high-dose steroid treatment and immunosuppressive treatment with cyclosporin A were initiated under the assumption of PG. Additionally, the patient was treated with hyperbaric oxygenation (HBO). The 2‑year follow-up showed a gradual restitution of the soft tissues.

KEYWORDS:

Antibiotic therapy; Hyperbaric oxygenation; Immunosuppressive therapy; Necrotizing fasciitis; Pyoderma gangrenosum; Surgical cleansing

PMID:
31392345
DOI:
10.1007/s00113-019-00704-6

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