Pyoderma gangrenosum or necrotizing fasciitis? A diagnostic conundrum. Case report and literature review

Abstract

2016-12-23T18:49:38

The role of negative pressure wound therapy (NPWT) on the treatment of pyoderma gangrenosum: A systematic review and personal experience

“…In most cases, this outcome occurred when NPWT was performed without association with systemic immunosuppressive therapy, which increases the likelihood of active disease, with an exacerbated inflammatory response. [28][29][30][31][32][33][34][35][36] One of the articles pointed out that NPWT was successful in one patient, acting as a bridge between the period of active PG and after the disease was stabilized with immunosuppression until the wound was closed. 8 However, there was a case report that no improvement with NPWT was observed, even in association with immunosuppressive therapy.…”

“…It was analysed patients who had a successful healing outcome, comparing those who performed NPWT with a skin graft (n = 34)22,[25][26][27][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] with those who performed NPWT alone (n = 13),20,21,24,33,44,[58][59][60][61][62][63][64][65] correlating with the healing time reported. 64.7% of patients who received NPWT with a skin graft (n = 22) had a healing time of less than or equal to 2 months, and 76.9% of patients who received NPWT alone (n = 10)…”

The diagnosis you wish you had never operated on: Pyoderma gangrenosum misdiagnosed as necrotizing fasciitis—a case report

“…In cases with trauma-induced pyoderma gangrenosum, deterioration of the general condition of the patient, elevated vital parameters, and elevated inflammatory markers can easily be perceived as signs of infection (Wangia et al. 2013, Barr et al. 2009, Bisarya et al.…”

Postsurgical Pyoderma Gangrenosum Requiring Plastic Surgical Intervention: A Practical Review

“…As laboratories are usually not helpful in differentiating these two entities, wound cultures, imaging, and histology are used. [49][50][51]52 (See…”

“…As laboratories are usually not helpful in differentiating these two entities, wound cultures, imaging, and histology are used. 49-51,52 ( See table, Supplemental Digital Content 2, which displays comparison of necrotizing fasciitis and PG. The table is taken from Bisarya et al, 52 with permission.…”