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Case Reports
. 2015 Jul 8;3(6):e434.
doi: 10.1097/GOX.0000000000000412. eCollection 2015 Jun.

Post Reconstruction Breast Pyoderma Gangrenosum: Early Recognition and Prosthesis Salvage

Bryan Cicuto  1 , Thomas Cheriyan  1 , Pamela Rudnicki  1 , Lifei Guo  1
Affiliations
Case Reports

Post Reconstruction Breast Pyoderma Gangrenosum: Early Recognition and Prosthesis Salvage

Bryan Cicuto et al. Plast Reconstr Surg Glob Open. .

Abstract

We report 3 cases of breast pyoderma gangrenosum in patients undergoing total mastectomy with immediate reconstruction. All three received systemic corticosteroid treatment, resulting in resolution of symptoms. As experience grew, early diagnosis in the third patient helped prosthesis salvage and timely return to the original course of reconstruction. This represents the first report of prosthesis salvage from post breast reconstruction pyoderma gangrenosum, and it demonstrates that implant removal is not always necessary during management of this rare condition.

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Conflict of interest statement

Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the authors.

Figures

Fig. 1.
Fig. 1.
A diagnosis of postsurgical pyoderma gangrenosum should be considered in cases of appearance of dermal yellow pustules with ulcerations that do not respond to antibiotic therapy at postoperative days 3–5.
Fig. 2.
Fig. 2.
Ulcerations seen on POD 10. On exploration, suture line skin edge necrosis was resected along with the surrounding ulcerative dermal tissue. There was no purulent drainage, fat necrosis, or fluid collection identified. Copious irrigation with antibiotic solution preceded partial tissue expander deflation to facilitate skin edge reapproximation, leaving the original tissue expander and Jackson-Pratt drain in place.
Fig. 3.
Fig. 3.
A–C, Histology of progressively higher powers of the dermal ulcerative specimen was consistent with the clinical diagnosis of pyoderma gangrenosum.
See this image and copyright information in PMC

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