Pyoderma (Echthyma) Gangrenosum

Brunsting, Louis A.

doi:10.1001/archderm.1930.01440160053009

Cited by 452 publications

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“…PG is a rare ulcerative disease first described in 1930 by Brunsting et al [3]. Despite this, its pathogenesis remains unknown, although it is considered an autoimmune disorder.…”

Section: Discussionmentioning

confidence: 99%

First Report of Pyoderma Gangrenosum after Surgery of Breast Cancer-Related Lymphedema with Transfer of Vascularized Free Lymph Nodes of the Groin and Simultaneous DIEP Flap

2016

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Background: Pyoderma gangrenosum (PG) is a rare cutaneous ulcerative disease that does not respond to antibiotics and worsens with surgical manipulation. This is the first report in the literature revealing that this disease complicates total microsurgical breast reconstruction associated with the transfer of free lymph nodes. Case Report: We report the case of a female patient who underwent left-breast microsurgical reconstruction with a deep inferior epigastric perforator (DIEP) flap and simultaneous transfer of vascularized free lymph nodes for the surgical treatment of secondary left upper-limb lymphedema, and who developed a severe PG of both the skin of the flap and the donor zone on postoperative day 7. After exclusion of other etiologies, treatment with high-dose corticosteroids and topical zinc sulfate was initiated. The flap was salvaged and breast cancer-related lymphedema (BCRL) surgery was definitively effective despite the PG. Conclusions: PG should be considered in the differential diagnosis of progressive cutaneous ulcers following surgical interventions, once infectious and ischemic etiologies have been excluded. Early initiation of immunosuppressive treatment can lead to preservation of the initial flap and function of the transferred lymph nodes in the case of microsurgical breast reconstruction with associated lymph node transfer.

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“…PG is a rare ulcerative disease first described in 1930 by Brunsting et al [3]. Despite this, its pathogenesis remains unknown, although it is considered an autoimmune disorder.…”

Section: Discussionmentioning

confidence: 99%

First Report of Pyoderma Gangrenosum after Surgery of Breast Cancer-Related Lymphedema with Transfer of Vascularized Free Lymph Nodes of the Groin and Simultaneous DIEP Flap

2016

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“…A primeira citação do PG foi realizada em 1916 por Brocq, e em 1930 descrita por Brunsting et al, 5 porém existem evidências de sua presença 100 anos antes dessa descrição, em um Atlas de Dermatologia do início do século XIX. 6 A lesão inicial consiste em nódulo ou pústula estéril, com base infiltrada, que rapidamente ulcera, atingindo dimensões variáveis.…”

Section: Discussionunclassified

Perfil clinicopatológico dos pacientes com pioderma gangrenoso do Hospital das Clínicas de Porto Alegre (RS) - Brasil (2000-2006)

Barbato

Bakos

Masiero

et al. 2008

An. Bras. Dermatol.

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Resumo: FUNDAMENTOS -O pioderma gangrenoso é doença neutrofílica pouco freqüente. Caracteriza-se por lesões cutâneas ulceradas, dolorosas, com bordas subminadas e violáceas. Os membros inferiores configuram o local mais acometido. Sua etiologia é incerta, mas em 50% dos casos encontra-se associação com outras doenças. A histopatologia é inespecífica, e o diagnóstico, essencialmente clínico. OBJETIVO -Avaliar o perfil clinicopatológico de pacientes com pioderma gangrenoso. MÉTODO -Estudo retrospectivo dos pacientes diagnosticados no período de 2000 a 2006 no Serviço de Dermatologia do Hospital de Clínicas de Porto Alegre. RESULTADOS -Foram observados 16 pacientes cuja idade média foi 49 anos, com predomínio do sexo feminino (62,5%). O perío-do médio entre início da doença e diagnóstico foi de 1,6 ano. A forma clínica predominante foi a ulcerativa (81,25%), e 87,5% das lesões localizavam-se nos membros inferiores. O sintoma mais freqüentemente associado foi dor local (37,5%). Doze pacientes (66%) apresentaram doenças sistêmicas concomitantes. Doença de Crohn, diabetes e colagenoses foram as principais comorbidades encontradas. O tratamento mais utilizado foi a corticoterapia sistêmica, associada ou não a outros medicamentos (50%), tendo 43,75% dos pacientes apresentado recidiva do quadro. CONCLUSÕES -Os dados avaliados condizem com os encontrados na literatura. As doenças associadas mais prevalentes foram ileí-te regional, diabetes melitus e afecções do tecido conectivo. O tratamento mais utilizado incluiu corticoterapia sistêmica. A maioria dos pacientes apresentou cicatrização completa , porém o número de recidivas foi elevado. Palavras-chave: Dermatopatias; Dermatopatias/diagnóstico; Pioderma gangrenoso; Úlcera cutânea Abstract: BACKGROUND -Pyoderma gangrenosum is an infrequent neutrophilic dermatosis. It presents more frequently with painful cutaneous ulcers, with undermined violaceous borders. The legs are most commonly affected. Etiology is uncertain, although there is an association with other diseases in 50% of the cases,. Histopathology is non-specific and diagnosis is mostly clinical. OBJECTIVE -To evaluate the clinical and pathological profile of a sample of patients with pyoderma gangrenosum. METHOD -This was a retrospective study performed with the patients diagnosed in the period

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“…Given the neutrophil predominate infiltrate seen on pathology; dapsone can be used in addition to steroids Treatment can also include cyclosporine A and in some cases tacrolimus. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] PG of the breast is extremely rare occurring in 3 in 1 million people in the United States. Approximately 70% of occurrences are associated with autoimmune diseases such as rheumatoid arthritis, ulcerative colitis, or hematologic diseases.…”

Section: Case Presentationmentioning

confidence: 99%

A case of breast pyoderma gangrenosum after skin tag removal

Hayakawa¹,

Guðjónsson²,

Chang³

et al. 2016

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The following case report describes a 66 years old female who developed pyoderma gangrenosum (PG) on her left breast after skin tag removal. PG is an inflammatory dermatosis often confused with necrotizing infection. It is linked to breast surgery especially in those with preexisting autoimmune disorders. Knowledge of PG occurring in the breast is essential for early diagnosis and proper treatment.

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Pyoderma (Echthyma) Gangrenosum

Cited by 452 publications

References 0 publications

First Report of Pyoderma Gangrenosum after Surgery of Breast Cancer-Related Lymphedema with Transfer of Vascularized Free Lymph Nodes of the Groin and Simultaneous DIEP Flap

First Report of Pyoderma Gangrenosum after Surgery of Breast Cancer-Related Lymphedema with Transfer of Vascularized Free Lymph Nodes of the Groin and Simultaneous DIEP Flap

Perfil clinicopatológico dos pacientes com pioderma gangrenoso do Hospital das Clínicas de Porto Alegre (RS) - Brasil (2000-2006)

A case of breast pyoderma gangrenosum after skin tag removal

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