Pyoderma Gangrenosum of the Eyelids: Recurrence in a Skin Graft

Melson, Mark R.; Grossniklaus, Hans E.; Murchison, Ann P.

doi:10.1097/iop.0b013e3181c0929a

Cited by 14 publications

(13 citation statements)

References 3 publications

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“…Ten articles were identified by handsearching the reference list of included studies. Finally, 102 17‐118 articles were included in this systematic review (Figure 1). The studies included were 53 case reports, 28 case series, 15 letters, and 6 conference abstracts published between 1930 and 2019.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of skin grafting in treatment of vasculitic ulcer and pyoderma gangrenosum—A systematic review

Morgenstjerne‐Schwenck

Knudsen

Prasad

2020

Wound Repair Regeneration

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Chronic painful ulcers caused by pyoderma gangrenosum (PG) and cutaneous vasculitis remain to be a therapeutic challenge. Skin grafts have been used with success in selected cases but are generally avoided due to the fear of pathergy. The aim of this study was to investigate the safety and efficacy of skin grafting in the treatment of primary vasculitic ulcer (PVU) and PG. MEDLINE, Embase, the Cochrane Library, http://clinicaltrial.gov, and WHO International Clinical Trials Registry Platform (ICTRP) were searched from inception to March 2020. A search for grey literature was conducted in May 2020. We included studies assessing the efficacy and safety of skin grafting in the treatment of PG and PVU. Studies were only included if skin grafting was performed after establishment of PG or PVU diagnosis. A total of 721 articles was identified through the database search of which 92 were included in this study. Ten articles were identified by handsearching the reference list of included studies. Finally, 102 articles describing 212 wounds in 153 patients were included. Complete healing was found in 75.5% of the wounds. The average time to complete was 10.8 weeks (95% CI 6.1‐15.6). The mean donor site healing time was 1.9 weeks (95% CI 0.52‐3.20). Pathergy was reported in 8 (5.2%) patients. One patient had severe infection related to skin grafting. A statistically significant difference in the number of patients receiving preoperative (P = .0079) and postoperative (P = .002) immunosuppressive therapy was found between the groups with complete healing/reduction and no improvement/aggravation. This systematic review finds the current evidence on efficacy and safety of skin grafting in treatment of PG and PVU to be promising but limited to the size and lack of studies superior to case reports and case series. Future placebo‐controlled trials are required to draw a stronger conclusion.

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Section: Resultsmentioning

confidence: 99%

Efficacy and safety of skin grafting in treatment of vasculitic ulcer and pyoderma gangrenosum—A systematic review

Morgenstjerne‐Schwenck

Knudsen

Prasad

2020

Wound Repair Regeneration

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“…As such, PG has been reported as a complication in various types of surgery including coronary artery bypass graft surgery, laparoscopic appendectomy, knee arthroscopy, lower extremity vascular bypass, abdominoplasty, skin grafting, breast reconstruction and free tissue transfer flaps. 4,[9][10][11][12][13][14][15] Within the past year, over 100 articles have been published describing the disease and its treatment. The increasing body of case reports within the literature demonstrates a growing awareness that PG can be associated with virtually any cutaneous manipulation regardless of how minimally invasive the procedure is perceived.…”

Section: Discussionmentioning

confidence: 99%

Pyoderma gangrenosum: a new complication after groin exposure for attempted endovascular aortic stent-graft placement

Gassman¹,

Sinno²,

Milner³

et al. 2011

Vascular

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Pyoderma gangrenosum (PG) is an uncommon and frequently misdiagnosed inflammatory dermatosis. This neutrophilic inflammation of the dermis has been well described in relation to other inflammatory illnesses (i.e. inflammatory bowel disease). Although rare, PG is increasingly described in relation to trauma or surgical interventions. It is important for vascular surgeons to be aware of the potential development of PG at vascular access sites. Although endovascular surgery is a minimally invasive form of vascular surgery, it does require cutaneous manipulation, which can incite PG. The purpose of this report is to describe a case of PG that developed after an attempted endovascular surgery and to elucidate this rare dermatologic disorder's diagnosis and treatment.

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“…Im Vergleich zur nekrotisierenden Fasziitis reicht die Infektion tiefer bis in den Bereich der Muskeln hinein [21]. Pyoderma gangrenosum ist eine destruktive Hauterkrankung, die nur selten den Kopfbereich betrifft, allerdings gibt es auch Berichte über eine Beteiligung und Nekrose der Augenlider [3,22]. Die Erkrankung geht oft mit systemischen, chronisch-entzündlichen Erkrankungen wie z.…”

Section: Diagnoseunclassified

“…Kleine Pusteln entwickeln sich zu tiefen Ulzera mit lividen erhabenen Rändern, wobei die Erkrankung deutlich langsamer fortschreitet als die nekrotisierende Fasziitis [6,11]. Eine chirurgische Behandlung ist kontraindiziert, da sie zu einer weiteren Ausbreitung der Erkrankung führen kann (Pathergiephänomen) [22,26]. Die Warfarin-Nekrose ist eine seltene Komplikation, die innerhalb der ersten 3 bis 10 Tage der Therapie mit Warfarin auftreten kann und durch einen transienten Hyperkoagulationszustand ausgelöst wird [27].…”

Section: Diagnoseunclassified