Dermatologic Complications Following Cosmetic and Reconstructive Plastic Surgery: A Systematic Review of the Literature

Early Diagnosis and Treatment of Pyoderma Gangrenosum: Reviewing Mobile Phone Photos Saved a Patient From Unnecessary Surgeries

“…Pyoderma gangrenosum is included among the dermatological complications that can affect plastic surgery procedures and is the most common and serious condition that can occur following surgery [1]. Its reported incidence has been found to be three cases per million per year in the USA [2,3].…”

“…Its rarity and the fact that its clinical features and presentation resemble that of infection commonly misdirects surgeons leading to significant delays in its diagnosis. The median time from symptom presentation and correct diagnosis has been found to be 15 days, delaying in some cases even years [1,5].…”

“…Studies have shown the breast as the area most frequently associated with the occurrence of pyoderma gangrenosum following surgery [1,6] and breast reduction as the operation most frequently related to its appearance [1,5]. Usually, it appears on the breast surgical incision site four days to six weeks following surgery, as wound dehiscence rapidly progresses to expanding ulceration commonly accompanied by fever [1,7,8].…”

“…Treatment involves the immediate initiation of immunomodulatory medication such as corticosteroids or cyclosporine until ulcer healing, for a duration of approximately 4-5 months with gradual dose tapering, and observation for possible recurrences [1,9].…”

“…Thus, investigation for such underlying pathologies is recommended upon establishment of diagnosis. However, in many cases, it has been noted in patients without a history of any predisposing factor [1].…”