Pyoderma gangrenosum associated with left iliac vein compression syndrome: presentation of difficult diagnosis

Freitas, Verena Mony Paes de; Pereira, Silvia Marcondes; Enokihara, Mílvia Maria Simões e Silva; Cestari, Silmara da Costa Pereira

doi:10.1590/abd1806-4841.20176109

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…We postulate that due to the sudden cessation of breastfeeding, our patient developed breast engorgement leading to increased pressure due to accumulated milk in the breast, which could have produced a similar effect as external compression. This lends credibility to the small pool of evidence that PG can be triggered by both internal and external compression of the skin [5,8,9].…”

Section: Discussionsupporting

confidence: 64%

“…The latest studies show that prolonged external compression of the skin, e.g., seat belt compression, has an important role in precipitating PG [ 5 , 8 ]. Compression of blood vessels causing arterial and venous insufficiency internally has also recently been reported to be a trigger factor in some cases other than external compression of the skin [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pyoderma Gangrenosum Precipitated by Breast Engorgement Following Lactation Discontinuation: A Rare Case Report

Sarwar¹,

Sajid²,

Wasim³

et al. 2023

Cureus

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Pyoderma gangrenosum (PG) is an inflammatory disease characterized by recurrent painful ulcers, eventually leading to cribriform scars. PG is mostly a diagnosis of exclusion with neutrophilic skin infiltration. We present a case of a 35-year-old female patient whose first presentation of PG occurred in the first trimester of pregnancy, which recurred after discontinuation of breastfeeding. The patient also had a history of taking prolonged IM and IV analgesics for her chronic migraines. The patient was initially treated with steroids and necessary wound care, during which symptoms remained controlled. However, a year later, the patient presented with an acute flare-up of the disease in her postpartum period, mainly involving her breasts bilaterally. Extensive wound debridement was performed due to the severity of her necrotic ulcers and failure to respond to conservative management, which was followed by partial thickness skin grafting.

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Section: Discussionsupporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Pyoderma Gangrenosum Precipitated by Breast Engorgement Following Lactation Discontinuation: A Rare Case Report

Sarwar¹,

Sajid²,

Wasim³

et al. 2023

Cureus

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“…In addition to more commonly seen infectious processes, such as the necrotizing fasciitis (NF) and erysipelas bullosum; sporotrichosis, blastomycosis, cryptococcosis can also mimic PG. 7,27,[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] Some inflammatory (Henoch-Schönlein purpura, 43 granulomatosis with polyangiitis 44 ); cancerous (mycosis fungoides, 45 anaplastic large-cell lymphoma 46 ); and miscellaneous (iliac vein compression syndrome, 47 bromoderma 48 ) disorders have similar presentation to PG, as well. One should also be able to set PG apart from pyogenic granuloma.…”

Section: Differential Diagnosismentioning

confidence: 99%

Postsurgical Pyoderma Gangrenosum Requiring Plastic Surgical Intervention: A Practical Review

Guliyeva,

Janis

2024

Plastic and Reconstructive Surgery - Global Open

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Summary: Pyoderma gangrenosum is a neutrophilic dermatosis characterized by immune dysfunction and pathergy. Thus, it is frequently seen in patients with underlying systemic illnesses or postoperatively. For the performance of the debridement or closure of the resultant defect, plastic surgeons are often involved in the care of pyoderma patients. However, both procedures may exacerbate the injury. Therefore, plastic surgeons must be familiar with the presentation of postsurgical pyoderma to avoid further damage and safely repair related soft tissue defects. A systematic search of the PubMed/Medline database was performed using the following keywords: “pyoderma gangrenosum” and “surgery.” This online database search has identified 656 studies published between 1958 and 2022. Only reconstructed cases of postsurgical pyoderma gangrenosum were selected. Twenty-eight patients who developed pyoderma after dermatologic, plastic, orthopedic, cardiovascular, general, or obstetric surgery were included in this study. The average time to the PG presentation and diagnosis was 5.5 and 17 days, respectively. Diagnostic scoring tools were not used, and the diagnosis was primarily based on histopathology after repeated treatment failures. The patients received split- or full-thickness skin grafts, local, pedicled, and free flaps. An estimated 82.1% underwent skin grafting, whereas 42.9% underwent flap reconstruction. In addition, 21.4% got both the graft and flap. Accurate diagnosis of PSPG, prevention of further surgical injury, and timely medical management are vital for improving patient outcomes. Reconstruction can be performed, if required. However, despite the availability of different reconstructive techniques, there is no standard approach to the management of the PSPG.

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Pyoderma gangrenosum: a review with special emphasis on Latin America literature

Rodríguez-Zúñiga

Heath

Gontijo

et al. 2019

Anais Brasileiros de Dermatologia

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Pyoderma gangrenosum is a neutrophilic dermatosis characterized by chronic ulcers due to an abnormal immune response. Despite the existence of diagnostic criteria, there is no gold standard for diagnosis or treatment. In Latin America, recognizing and treating pyoderma gangrenosum is even more challenging since skin and soft tissue bacterial and non-bacterial infections are common mimickers. Therefore, this review aims to characterize reported cases of pyoderma gangrenosum in this region in order to assist in the assessment and management of this condition. Brazil, Mexico, Argentina, and Chile are the countries in Latin America that have reported the largest cohort of patients with this disease. The most frequent clinical presentation is the ulcerative form and the most frequently associated conditions are inflammatory bowel diseases, inflammatory arthropaties, and hematologic malignancies. The most common treatment modalities include systemic corticosteroids and cyclosporine. Other reported treatments are methotrexate, dapsone, and cyclophosphamide. Finally, the use of biological therapy is still limited in this region.

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Pyoderma gangrenosum associated with left iliac vein compression syndrome: presentation of difficult diagnosis

Cited by 4 publications

References 12 publications

Pyoderma Gangrenosum Precipitated by Breast Engorgement Following Lactation Discontinuation: A Rare Case Report

Pyoderma Gangrenosum Precipitated by Breast Engorgement Following Lactation Discontinuation: A Rare Case Report

Postsurgical Pyoderma Gangrenosum Requiring Plastic Surgical Intervention: A Practical Review

Pyoderma gangrenosum: a review with special emphasis on Latin America literature

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