PG remains a diagnosis of exclusion and one not often seen by surgical specialties outside of Dermatology.
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It can mimic many other cutaneous conditions including bacterial infection, vascular occlusive disease and chronic non-healing wounds.
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Misdiagnosis often leads to mismanagement and aggressive surgical debridement.
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Recognizing the clinical features of PG and its pathergenic nature while ensuring timely management is fundamental to preventing severe destruction and deformity.
Abstract
Introduction
Pyoderma gangrenosum is a chronic neutrophilic dermatosis which can occur following trauma or surgery and can mimic infection. Surgical intervention can lead to progression of disease.
Presentation of cases
This case series describes 3 cases of post-surgical pyoderma gangrenosum with delayed diagnosis from two large medical centers.
Discussion
Epidemiology, pathogenesis, clinical and histopathologic presentation, and management of post-surgical pyoderma gangrenosum are discussed with a review of the literature.
Conclusion
Post-surgical pyoderma gangrenosum (PSPG) can mimic ulcerative disorders including bacterial infection. The diagnosis should be suspected in post-operative wounds with negative bacterial cultures which progress despite broad-spectrum antibiotics and surgical debridement. Recognizing the clinical features of PSPG is fundamental to prevent severe destruction and deformity.