[Postoperative pyoderma gangrenosum]

Abstract

Post-traumatic pyoderma gangrenosum is an ulceronecrotizing dermatosis that is rare and therefore often misinterpreted. After excision of an orbit pseudotumor by otorhinolaryngological surgeons, a 77-year-old woman developed a multifocal ulcerous wound dehiscence. Although the case history, development and clinical picture were characteristic, the correct diagnosis was established and successfully treated 6 months later by a consulting dermatologist. Postoperative pyoderma gangrenosum should be taken into consideration if a sterile, painful, chronically progressive, ulcerative and sludgy defect develops after surgery. The preoperative investigation should include pyoderma gangrenosum in the personal history and take associated diseases into account (e.g., inflammatory bowel diseases, blood diseases, rheumatological diseases and vasculitis) to provide prophylactic immunosuppressive pharmacotherapy. In minimally invasive or cosmetic surgery these aspects may have a forensic impact, as pyoderma gangrenosum heals with atrophic scars. The purpose of this paper was to describe the clinical characteristics of pyoderma gangrenosum, its prevention and its therapy.