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Post-Operative Pyoderma Gangrenosum: A Long Journey for a Patient with Myelodysplastic Syndrome

Pyoderma gangrenosum (PG) is an inflammatory neutrophilic dermatosis, characterized by painful and erythematous papules, pustules or vesicles that rapidly become ulcerative and necrotic. These ulcers have multiple sub-types and can develop anywhere on the body. There are different postulations as to...

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Autor principal: Tagliaferri, Ariana R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7511067/
https://www.ncbi.nlm.nih.gov/pubmed/32983685
http://dx.doi.org/10.7759/cureus.9984
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author Tagliaferri, Ariana R
author_facet Tagliaferri, Ariana R
author_sort Tagliaferri, Ariana R
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description Pyoderma gangrenosum (PG) is an inflammatory neutrophilic dermatosis, characterized by painful and erythematous papules, pustules or vesicles that rapidly become ulcerative and necrotic. These ulcers have multiple sub-types and can develop anywhere on the body. There are different postulations as to the mechanisms of development for each sub-type. More than half of patients with PG have an underlying disease, with the highest prevalence being inflammatory bowel disease (IBD), followed by inflammatory arthritis and hematological disorders. Post-operative PG should be considered in any patient undergoing surgery who subsequently develops characteristic necrotic lesions with delayed wound healing, fever and severe localized pain. The clinical manifestations and treatment may differ slightly depending on the type and cause of PG. Herein, we present a patient with myelodysplastic syndrome and arthritis, who underwent surgery for diverticulosis complicated by colovaginal fistula formation, and subsequently developed a very prolonged course of post-operative pyoderma gangrenosum. This report will address the types of PG, their various manifestations and pathogenesis, as well as the management specific to patients with myelodysplastic syndrome. It is our intent to better understand the sub-types in order to predict and prevent post-operative PG.
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spelling pubmed-75110672020-09-24 Post-Operative Pyoderma Gangrenosum: A Long Journey for a Patient with Myelodysplastic Syndrome Tagliaferri, Ariana R Cureus Medical Education Pyoderma gangrenosum (PG) is an inflammatory neutrophilic dermatosis, characterized by painful and erythematous papules, pustules or vesicles that rapidly become ulcerative and necrotic. These ulcers have multiple sub-types and can develop anywhere on the body. There are different postulations as to the mechanisms of development for each sub-type. More than half of patients with PG have an underlying disease, with the highest prevalence being inflammatory bowel disease (IBD), followed by inflammatory arthritis and hematological disorders. Post-operative PG should be considered in any patient undergoing surgery who subsequently develops characteristic necrotic lesions with delayed wound healing, fever and severe localized pain. The clinical manifestations and treatment may differ slightly depending on the type and cause of PG. Herein, we present a patient with myelodysplastic syndrome and arthritis, who underwent surgery for diverticulosis complicated by colovaginal fistula formation, and subsequently developed a very prolonged course of post-operative pyoderma gangrenosum. This report will address the types of PG, their various manifestations and pathogenesis, as well as the management specific to patients with myelodysplastic syndrome. It is our intent to better understand the sub-types in order to predict and prevent post-operative PG. Cureus 2020-08-24 /pmc/articles/PMC7511067/ /pubmed/32983685 http://dx.doi.org/10.7759/cureus.9984 Text en Copyright © 2020, Tagliaferri et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Medical Education
Tagliaferri, Ariana R
Post-Operative Pyoderma Gangrenosum: A Long Journey for a Patient with Myelodysplastic Syndrome
title Post-Operative Pyoderma Gangrenosum: A Long Journey for a Patient with Myelodysplastic Syndrome
title_full Post-Operative Pyoderma Gangrenosum: A Long Journey for a Patient with Myelodysplastic Syndrome
title_fullStr Post-Operative Pyoderma Gangrenosum: A Long Journey for a Patient with Myelodysplastic Syndrome
title_full_unstemmed Post-Operative Pyoderma Gangrenosum: A Long Journey for a Patient with Myelodysplastic Syndrome
title_short Post-Operative Pyoderma Gangrenosum: A Long Journey for a Patient with Myelodysplastic Syndrome
title_sort post-operative pyoderma gangrenosum: a long journey for a patient with myelodysplastic syndrome
topic Medical Education
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7511067/
https://www.ncbi.nlm.nih.gov/pubmed/32983685
http://dx.doi.org/10.7759/cureus.9984
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