Necrotic ulcerations after splenectomy

Postoperative pyoderma gangrenosum (PG): The Mayo Clinic experience of 20 years from 1994 through 2014

“…IgM monoclonal gammopathy of unknown significance was present in a patient with PG and RA, whereas the patient with myelofibrosis had a transformation of his polycythemia vera for which he had the splenectomy leading to postoperative PG. 42 Notably, none of our patients had an IgA monoclonal gammopathy often associated with PG. Positive connective tissue autoantibodies were present in 3 patients, with 1 patient actually carrying a diagnosis of RA.…”

“…34,35 Atypical and bullous types of PG are often associated with hematologic disorders and have been noted as a presenting sign of leukemia with some cases overlapping with Sweet syndrome. 32,[36][37][38][39][40][41][42] In a review of literature, around 35% of patients with postoperative PG had an associated systemic disease or a personal history of PG, with the majority of patients not having a predisposing comorbidity except surgery. 3,4 This is a greater systemic disease association compared with our cohort of 22% of postoperative PG cases; however, the lack of a standardized evaluation at our institution may be a confounding factor.…”

Postsurgical Pyoderma Gangrenosum Requiring Plastic Surgical Intervention: A Practical Review

“…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.…”

“…19 Atypical or bullous PG lesions can manifest as plaques, nodules, vesicles, or bullae. 14,19,43,56,56 This PG variant is more associated with blood disorders, such as myelodysplastic disorders and monoclonal gammopathies, and blind loops. 19 Patients with IBD are also prone to develop parastomal PG.…”