Pyoderma gangrenosum as a differential diagnosis of ischemic and infectious complications after abdominoplasty: a case report
Introduction: Abdominoplasty is a procedure with a considerable rate of complications, even though, for the most part, it has a good prognosis. Some complications, however, can be catastrophic, such as extensive skin necrosis and serious infectious complications. Among the unusual causes of extensiv...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Sociedade Brasileira de Cirurgia Plástica
2021-06-01
|
| Series: | Revista Brasileira de Cirurgia Plástica |
| Subjects: | |
| Online Access: | http://www.rbcp.org.br/export-pdf/2948/en_v36n2a15.pdf |
| _version_ | 1797425979818246144 |
|---|---|
| author | Isabel Cristina Wiener Stensmann Ciro Paz Portinho Gustavo de Azambuja Pereira Eduardo Madalosso Zanin Monica Alexandra Jimenez Zerpa Antonio Carlos Pinto Oliveira Marcus Vinicius Martins Collares |
| author_facet | Isabel Cristina Wiener Stensmann Ciro Paz Portinho Gustavo de Azambuja Pereira Eduardo Madalosso Zanin Monica Alexandra Jimenez Zerpa Antonio Carlos Pinto Oliveira Marcus Vinicius Martins Collares |
| author_sort | Isabel Cristina Wiener Stensmann |
| collection | DOAJ |
| description | Introduction: Abdominoplasty is a procedure with a considerable rate of complications, even though, for the most part, it has a good prognosis. Some complications, however, can be catastrophic, such as extensive skin necrosis and serious infectious complications. Among the unusual causes of extensive skin loss in the postoperative period, we can mention gangrenous pyoderma (PG), a chronic, recurrent disease with unpredictable behavior and an unknown etiology. In the field of plastic surgery, this disease can clinically mimic ischemic or infectious postoperative complications, whose treatments differ completely from the treatment of PG.
Case Report: A 41-year-old female patient, previously healthy, underwent abdominoplasty associated with liposuction and breast augmentation with the placement of breast implants. The patient evolved with edema, hyperemia and pain in an abdominoplasty incision, in addition to systemic clinical involvement. She was submitted to surgical debridement and systemic treatment, with progressive worsening of the lesions. In view of the failure of the proposed treatments, the diagnostic hypothesis of gangrenous pyoderma was raised.
Conclusion: PG, although rare, should be considered as a differential diagnosis in cases of postoperative complications with skin loss and necrosis that do not respond to initial treatment measures, in addition to apparently infectious conditions that do not respond to adopted antibiotic therapies. |
| first_indexed | 2024-03-09T08:23:46Z |
| format | Article |
| id | doaj.art-8b0bd4adf81f44ab8e0fd10427b1d592 |
| institution | Directory Open Access Journal |
| issn | 1983-5175 2177-1235 |
| language | English |
| last_indexed | 2024-03-09T08:23:46Z |
| publishDate | 2021-06-01 |
| publisher | Sociedade Brasileira de Cirurgia Plástica |
| record_format | Article |
| series | Revista Brasileira de Cirurgia Plástica |
| spelling | doaj.art-8b0bd4adf81f44ab8e0fd10427b1d5922023-12-02T21:33:34ZengSociedade Brasileira de Cirurgia PlásticaRevista Brasileira de Cirurgia Plástica1983-51752177-12352021-06-01360221021610.5935/2177-1235.2021RBCP0069Pyoderma gangrenosum as a differential diagnosis of ischemic and infectious complications after abdominoplasty: a case reportIsabel Cristina Wiener Stensmann0Ciro Paz Portinho1Gustavo de Azambuja Pereira2Eduardo Madalosso Zanin3Monica Alexandra Jimenez Zerpa4Antonio Carlos Pinto Oliveira5Marcus Vinicius Martins Collares6Hospital de Clínicas de Porto Alegre, Plastic Surgery Service, Porto Alegre, RS, BrazilHospital de Clínicas de Porto Alegre, Plastic Surgery Service, Porto Alegre, RS, BrazilSanta Casa de Misericórdia de Porto Alegre, Department of Plastic Surgery, Porto Alegre, RS, BrazilHospital de Clínicas de Porto Alegre, Plastic Surgery Service, Porto Alegre, RS, BrazilHospital de Clínicas de Porto Alegre, Plastic Surgery Service, Porto Alegre, RS, BrazilHospital de Clínicas de Porto Alegre, Plastic Surgery Service, Porto Alegre, RS, BrazilHospital de Clínicas de Porto Alegre, Plastic Surgery Service, Porto Alegre, RS, BrazilIntroduction: Abdominoplasty is a procedure with a considerable rate of complications, even though, for the most part, it has a good prognosis. Some complications, however, can be catastrophic, such as extensive skin necrosis and serious infectious complications. Among the unusual causes of extensive skin loss in the postoperative period, we can mention gangrenous pyoderma (PG), a chronic, recurrent disease with unpredictable behavior and an unknown etiology. In the field of plastic surgery, this disease can clinically mimic ischemic or infectious postoperative complications, whose treatments differ completely from the treatment of PG. Case Report: A 41-year-old female patient, previously healthy, underwent abdominoplasty associated with liposuction and breast augmentation with the placement of breast implants. The patient evolved with edema, hyperemia and pain in an abdominoplasty incision, in addition to systemic clinical involvement. She was submitted to surgical debridement and systemic treatment, with progressive worsening of the lesions. In view of the failure of the proposed treatments, the diagnostic hypothesis of gangrenous pyoderma was raised. Conclusion: PG, although rare, should be considered as a differential diagnosis in cases of postoperative complications with skin loss and necrosis that do not respond to initial treatment measures, in addition to apparently infectious conditions that do not respond to adopted antibiotic therapies.http://www.rbcp.org.br/export-pdf/2948/en_v36n2a15.pdfabdominoplastypyoderma gangrenosumpostoperative complicationsvesiculobullic dermatopathiesdifferential diagnosis |
| spellingShingle | Isabel Cristina Wiener Stensmann Ciro Paz Portinho Gustavo de Azambuja Pereira Eduardo Madalosso Zanin Monica Alexandra Jimenez Zerpa Antonio Carlos Pinto Oliveira Marcus Vinicius Martins Collares Pyoderma gangrenosum as a differential diagnosis of ischemic and infectious complications after abdominoplasty: a case report Revista Brasileira de Cirurgia Plástica abdominoplasty pyoderma gangrenosum postoperative complications vesiculobullic dermatopathies differential diagnosis |
| title | Pyoderma gangrenosum as a differential diagnosis
of ischemic and infectious complications after
abdominoplasty: a case report |
| title_full | Pyoderma gangrenosum as a differential diagnosis
of ischemic and infectious complications after
abdominoplasty: a case report |
| title_fullStr | Pyoderma gangrenosum as a differential diagnosis
of ischemic and infectious complications after
abdominoplasty: a case report |
| title_full_unstemmed | Pyoderma gangrenosum as a differential diagnosis
of ischemic and infectious complications after
abdominoplasty: a case report |
| title_short | Pyoderma gangrenosum as a differential diagnosis
of ischemic and infectious complications after
abdominoplasty: a case report |
| title_sort | pyoderma gangrenosum as a differential diagnosis of ischemic and infectious complications after abdominoplasty a case report |
| topic | abdominoplasty pyoderma gangrenosum postoperative complications vesiculobullic dermatopathies differential diagnosis |
| url | http://www.rbcp.org.br/export-pdf/2948/en_v36n2a15.pdf |
| work_keys_str_mv | AT isabelcristinawienerstensmann pyodermagangrenosumasadifferentialdiagnosisofischemicandinfectiouscomplicationsafterabdominoplastyacasereport AT ciropazportinho pyodermagangrenosumasadifferentialdiagnosisofischemicandinfectiouscomplicationsafterabdominoplastyacasereport AT gustavodeazambujapereira pyodermagangrenosumasadifferentialdiagnosisofischemicandinfectiouscomplicationsafterabdominoplastyacasereport AT eduardomadalossozanin pyodermagangrenosumasadifferentialdiagnosisofischemicandinfectiouscomplicationsafterabdominoplastyacasereport AT monicaalexandrajimenezzerpa pyodermagangrenosumasadifferentialdiagnosisofischemicandinfectiouscomplicationsafterabdominoplastyacasereport AT antoniocarlospintooliveira pyodermagangrenosumasadifferentialdiagnosisofischemicandinfectiouscomplicationsafterabdominoplastyacasereport AT marcusviniciusmartinscollares pyodermagangrenosumasadifferentialdiagnosisofischemicandinfectiouscomplicationsafterabdominoplastyacasereport |