Surgical Management of Pyoderma Gangrenosum: Case Report and Review

Alam, Murad; Grossman, Marc E.; Schneiderman, Paul I.; Blume, R; Benvenisty, Alan I.

doi:10.1046/j.1524-4725.2000.0260111063.x

Cited by 26 publications

(24 citation statements)

References 44 publications

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“…Specifically regarding the use of corticosteroids, initially high doses of prednisolone (approximately 100 to 200 mg/day) or prednisone (60–80 mg/day) are usually required. Moreover, the surgical management of inflammatory bowel disease may have a role in the treatment of secondary PG in patients who are unstable and refractory to drugs [6]. …”

Section: Introductionmentioning

confidence: 99%

Pyoderma Gangrenosum Simulating Necrotizing Fasciitis

Souza

Silva

Santos

et al. 2015

Case Reports in Medicine

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Pyoderma gangrenosum received this name due to the notion that this disease was related to infections caused by bacteria in the genus Streptococcus. In contrast to this initial assumption, today the disease is thought to have an autoimmune origin. Necrotizing fasciitis was first mentioned around the fifth century AD, being referred to as a complication of erysipelas. It is a disease characterized by severe, rapidly progressing soft tissue infection, which causes necrosis of the subcutaneous tissue and the fascia. On the third day of hospitalization after antecubital venipuncture, a 59-year-old woman presented an erythematous and painful pustular lesion that quickly evolved into extensive ulceration circumvented by an erythematous halo and accompanied by toxemia. One of the proposed etiologies was necrotizing fasciitis. The microbiological results were all negative, while the histopathological analysis showed epidermal necrosis and inflammatory infiltrate composed predominantly of dermal neutrophils. Pyoderma gangrenosum was considered as a diagnosis. After 30 days, the patient was discharged with oral prednisone (60 mg/day), and the patient had complete healing of the initial injury in less than two months. This case was an unexpected event in the course of the hospitalization which was diagnosed as pyoderma gangrenosum associated with myelodysplastic syndrome.

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Section: Introductionmentioning

confidence: 99%

Pyoderma Gangrenosum Simulating Necrotizing Fasciitis

Souza

Silva

Santos

et al. 2015

Case Reports in Medicine

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“…As observed in our patient, chemotherapy for the underlying malignant disorder often results in healing of the lesion [21]. In refractory cases, or cases not associated with an underlying disorder, systemic therapies administered in the treatment of classical pyoderma gangrenosum have included minocycline, dapsone, corticosteroids, cyclosporine, azathioprine, tacrolimus, hyperbaric oxygen and amputation [9,16,26,27]. Pathergy makes avoidance of debridement essential [16].…”

Section: Discussionmentioning

confidence: 92%

Bullous pyoderma gangrenosum as the presenting sign of fatal acute myelogenous leukemia

Fox

Geyer

Husain

et al. 2006

Leukemia & Lymphoma

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Bullous pyoderma gangrenosum begins as a bulla, nodule or nonulcerated erythematous plaque that blisters or ulcerates to form a superficial ulcer surrounded by a hemorrhagic, bullous border, which is surrounded by a blue-gray halo. Bullous pyoderma gangrenosum is most commonly associated with hematologic malignancies, specifically, acute myelogenous leukemia (AML). We report a patient whose initial presentation with bullous pyoderma gangrenosum prompted the appropriate diagnostic evaluation and confirmation of AML, which was ultimately fatal. We emphasize that a thorough hematologic investigation, including bone marrow biopsy, should be performed in all patients who present with lesions clinically suggestive of bullous pyoderma gangrenosum because the skin lesion may be the only indicator of the underlying hematologic disorder.

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“…6 Surgical debridement is occasionally useful, particularly if there is a large amount of necrotic eschar, and grafting may be considered to accelerate healing. 7,8 To avoid pathergy, these procedures should be performed under immunosuppressant cover, after disease activity has been controlled.…”

Section: Discussionmentioning

confidence: 99%