Un Pyoderma Gangrenosum post-opératoire mimant un choc septique

Robbins, A.; Mestrallet, S.; Dutel-Charneux, J.

doi:10.1016/j.revmed.2015.03.075

Cited by 1 publication

(3 citation statements)

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“…The clinical course of PPG is rarely as severe as in this patient, although a few cases of acute, rapidly evolving neutrophilic dermatoses have been reported. 2,3,7,9,10 The diagnosis of PPG is challenging. It is often misdiagnosed as a postoperative infection.…”

Section: Discussionmentioning

confidence: 99%

“…1 The most likely pathologic mechanism of the multiorgan failure in PPG is excessive expression of pro-inflammatory cytokines or systemic inflammatory response syndrome secondary to extensive skin lesions. [6][7][8][9] PG is usually associated with systemic disease like inflammatory bowel diseases, rheumatoid arthritis and myeloproliferative disorders. In contrast to idiopathic PG, PPG has a lower association with these systemic diseases.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, PPG can present as a more severe disease, sometimes with systemic features 1 . The most likely pathologic mechanism of the multiorgan failure in PPG is excessive expression of pro‐inflammatory cytokines or systemic inflammatory response syndrome secondary to extensive skin lesions 6–9 …”

Section: Introductionmentioning

confidence: 99%

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Pyoderma gangrenosum with severe systemic features, after augmentation mammoplasty

Beeckman,

Peeters,

Coyette

et al. 2023

JEADV Clinical Practice

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We report a rare life‐threatening presentation of postsurgical pyoderma gangrenosum (PG) after augmentation mammoplasty in a 32‐year‐old woman. Six days after surgery, the patient presented with fever and erythema at surgical wounds. In view of a suspected postsurgical infection, the patient was first treated with antibiotics and removal of breast protheses. In spite of this treatment, in a few days the patient developed a state of shock with multiorgan failure. The antibiotic coverage was broadened several times and multiple extensive surgical debridement with resection of the mammary glands were performed but did not improve the clinical situation. Twelve days after admission, the diagnosis of PG with systemic features was suspected and clinical improvement was observed within 24 h of methylprednisolone administration. PG can mimic the cutaneous and systemic features of necrotizing wound infection of surgical site. Biopsy and culture are critical to differentiating necrotizing neutrophilic dermatosis from necrotizing infection. The diagnosis of this less common form of PG is challenging and this case highlights how the frequent misdiagnosis with infection may result in ineffective antibiotic treatment and how the unnecessary surgical debridement may prolong and exacerbate the condition.

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