Atypical pyoderma gangrenosum following total knee replacement surgery: first report in dermatologic literature

Verma, Shyam

doi:10.1590/s0365-05962009000600020

Cited by 19 publications

(6 citation statements)

References 7 publications

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“…Thus, PG is frequently misdiagnosed. There have been seven previous cases 2 – 8 that followed TKA. All cases were initially misdiagnosed as wound infection.…”

Section: Discussionmentioning

confidence: 99%

“…Although rare, PG is known to occur following trauma or operative procedures. 1 Thus far, seven cases [2][3][4][5][6][7][8] have been reported following total knee arthroplasty (TKA), all of which used routine tissue culture for differential diagnosis; notably, this culture method resulted in delayed diagnosis. Herein, we report a case of PG following knee arthroplasty, in which we used shotgun metagenomics for rapid differential diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of metagenomic analysis in differential diagnosis for pyoderma gangrenosum

Chen

Huang

et al. 2018

J Int Med Res

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Pyoderma gangrenosum (PG) is a rare ulcerative inflammatory dermatosis easily confused with wound infection following surgery. There have been seven case reports of PG occurring after total knee arthroplasty (TKA), all of which used routine tissue culture for differential diagnosis. Notably, all previous cases involved delayed diagnosis. We report a case of PG after TKA where we used shotgun metagenomics for differential diagnosis. Metagenomic analysis is a new method that can be used for pathogen detection; it is fast and sensitive, compared with traditional culture. Early application of metagenomic analysis in cases of suspicious wound infection after surgery can detect the pathogen of the infection for target therapy; it can also exclude infection for differential diagnosis of non-infectious diseases, such as autoimmune disorders. This case is presented to support the use of metagenomic analysis by surgeons and physicians for early and rapid differential diagnosis in patients who exhibit postoperative wound infections.

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“…Thus, PG is frequently misdiagnosed. There have been seven previous cases 2 – 8 that followed TKA. All cases were initially misdiagnosed as wound infection.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Usefulness of metagenomic analysis in differential diagnosis for pyoderma gangrenosum

Chen

Huang

et al. 2018

J Int Med Res

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“…11 Bunlar dışında total diz replasman cerrahisi ve ül-seratif kolit ile ilişkili büllöz piyoderma gangrenozum olguları bulunmaktadır. 2,12 Olgumuzda büllöz lezyonların hızlı bir şekilde ortaya çıkması, lezyonun ağrılı olması, yara kültü-ründe üreme olmaması, klinik görünümü ve dermatopatolojik özellikleri ile piyoderma gangrenozum düşünülmüştür. Eşlik eden akciğer tüber-külozu ve tüberkülozun tedavisi ile gerileme gös-termesi nedeni ile piyoderma gangrenozum tüberküloz ile ilişkilendirilmiştir.…”

Section: Discussionunclassified

Bullous Pyoderma Gangrenosum Associated with Pulmonary Tuberculosis: Case Report

Koçak¹,

Koçak²,

Akay³

et al. 2015

Turkiye Klinikleri J Case Rep

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490P iyoderma gangrenozum, nadir görülen, ağrılı nekrotik ülserlerle karakterli nötrofilik bir dermatozdur. Olguların yaklaşık %50'sinde eşlik eden sistemik hastalık bulunmaktadır.1,2 Klasik, büllöz, püstü-ler, vejetatif ve peristomal olmak üzere beş klinik varyantı bulunmaktadır. 3Bu çalışmada, akciğer tüberkülozu tedavisi almakta olan bir olguda gelişen büllöz piyoderma gangrenozum, nadir görülmesi nedeni ile tüberküloza eşlik edebilecek hastalıklara dikkat çekmek amacıyla sunulmuştur.Akciğer Tüberkülozu ile İlişkili Büllöz Piyoderma Gangrenozum Ö ÖZ ZE ET T Piyoderma gangrenozum, etiyopatogenezi tam olarak bilinemeyen nötrofilik bir dermatozdur. Klinik olarak lezyon püstül, nodül veya bül ile başlar ve hızla ilerleyerek içe doğru kıvrımlı, kalkık kenarlı ağrılı ülserasyonlara dönüşebilir. Piyoderma gangrenozum, klinik bulgularına göre ülseratif, büllöz, vejetatif, püstüler ve peristomal olmak üzere beş ana grupta sınıflandırılmıştır. Büllöz piyoderma gangrenozum sıklıkla lenfoproliferatif hastalıklar, inflamatuar barsak hastalığı ve romatoid artritle ilişkilendirilmiştir. Literatürde daha önce deri tüberkülozu, kolon tüberkülozu ve testiküler tüberküloz ile ilişkili piyoderma gangrenozum olguları bildirilmiştir. Bu çalışmada, akciğer tüberkülozu sırasında ortaya çıkan ve antitüberküloz tedavi ile gerileme gösteren bir bül-löz piyoderma gangrenozum olgusu sunulmuştur. Bildiğimiz kadarıyla, olgumuz akciğer tüberkü-lozu ile ilişkilendirilen ilk büllöz piyoderma gangrenozum olgusudur.

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“…Unfortunately, some PG ulcers may take months or years to completely heal with systemic treatment alone, and even in patients with adequate medical therapy, this may not be sufficient. Even if local debridement and compression dressings treatment alone (where systemic therapy was impracticable) have been described in a few cases (8), surgery should be avoided (9), especially during the active phase of PG, because trauma (10) and surgical trauma (11–14) have been accounted to be a potential trigger of PG [pathergy, a phenomenon by which minor trauma can result in progressive destruction of healthy‐appearing skin (5)]. The rationale for surgical treatment is limited to sepsis prevention in immunosuppressed patients with extensive open surgical wounds.…”

Section: Discussionmentioning

confidence: 99%

Gauze‐based negative pressure wound therapy: a valid method to manage pyoderma gangrenosum

Fraccalvieri

Fierro

Salomone

et al. 2012

International Wound Journal

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Pyoderma gangrenosum (PG) is an uncommon ulcerative, non-infective chronic inflammatory skin disorder of unknown aetiology. Systemic therapies are necessary to control the associated medical diseases, and, due to the inflammatory nature of PG, topical or systemic immunosuppressant agents are effective, but wound healing is usually slow. Negative wound pressure therapy (NPWT) has become an important tool for the management of complex skin ulcers, and usage in PG has been recently described in the literature: we present four cases of classic PG in which NPWT in association with systemic therapy achieved wound healing and a drastic pain reduction.

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Atypical pyoderma gangrenosum following total knee replacement surgery: first report in dermatologic literature

Cited by 19 publications

References 7 publications

Usefulness of metagenomic analysis in differential diagnosis for pyoderma gangrenosum

Usefulness of metagenomic analysis in differential diagnosis for pyoderma gangrenosum

Bullous Pyoderma Gangrenosum Associated with Pulmonary Tuberculosis: Case Report

Gauze‐based negative pressure wound therapy: a valid method to manage pyoderma gangrenosum

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