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Post-operative pyoderma gangrenosum in association with ileal carcinoid tumour.

Campbell W, Baird E, Murtagh K, Eedy D, Hannon R - Ulster Med J (2010)

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Pyoderma gangrenosum (PG) is an uncommon, progressive ulcerative condition of skin... It is frequently confused with other more common ulcerating skin conditions such as necrotising fasciitis, vasculitis, pustular drug reactions and skin infections... Since surgery may be used to treat some of these conditions, but is relatively contraindicated in PG, early diagnosis is critical and is usually made in conjunction with a dermatologist... He required 4 further debridement's with intermittent returns to the intensive care unit for supportive therapy (Figure 2)... Microbiology of the skin specimens was insignificant and pathology described neutrophillic abscesses with no evidence of vasculitis, granulomatous inflammation or metastatic tumour... The literature yields only one other case connecting PG with carcinoid tumour, while most reports correlate the occurrence of PG to trauma, typically surgery... The delay in the recognition of this serious dermatological condition was associated with increased morbidity for our patient... PG is a serious and potentially fatal skin condition when correct treatment is not quickly commenced... Management is relatively simple once recognised with the use of corticosteroids and immunosuppressant... Surgery is not thought to be beneficial and in many circumstances can worsen the condition... We recommend that in any significant skin condition, particularly post-operatively or in one not responding to treatment effectively, one must seek the early advice of a dermatologist and not be guided primarily by histology.

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Early violaceous change around a laparoscopic port site
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fig1: Early violaceous change around a laparoscopic port site

Mentions: On day 7 this man's left iliac fossa port site was noted to be indurated and erythematous. Cefuroxime was empirically commenced for a presumed wound infection. He became pyrexic with a leukocytosis of 30,000 mm3 and skin at the port site quickly became sloughly and ischaemic (Figure 1). Following debridement he required transfer to intensive care as a case of suspected necrotising fasciitis.


Post-operative pyoderma gangrenosum in association with ileal carcinoid tumour.

Campbell W, Baird E, Murtagh K, Eedy D, Hannon R - Ulster Med J (2010)

Early violaceous change around a laparoscopic port site
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2993144&req=5

fig1: Early violaceous change around a laparoscopic port site
Mentions: On day 7 this man's left iliac fossa port site was noted to be indurated and erythematous. Cefuroxime was empirically commenced for a presumed wound infection. He became pyrexic with a leukocytosis of 30,000 mm3 and skin at the port site quickly became sloughly and ischaemic (Figure 1). Following debridement he required transfer to intensive care as a case of suspected necrotising fasciitis.

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Pyoderma gangrenosum (PG) is an uncommon, progressive ulcerative condition of skin... It is frequently confused with other more common ulcerating skin conditions such as necrotising fasciitis, vasculitis, pustular drug reactions and skin infections... Since surgery may be used to treat some of these conditions, but is relatively contraindicated in PG, early diagnosis is critical and is usually made in conjunction with a dermatologist... He required 4 further debridement's with intermittent returns to the intensive care unit for supportive therapy (Figure 2)... Microbiology of the skin specimens was insignificant and pathology described neutrophillic abscesses with no evidence of vasculitis, granulomatous inflammation or metastatic tumour... The literature yields only one other case connecting PG with carcinoid tumour, while most reports correlate the occurrence of PG to trauma, typically surgery... The delay in the recognition of this serious dermatological condition was associated with increased morbidity for our patient... PG is a serious and potentially fatal skin condition when correct treatment is not quickly commenced... Management is relatively simple once recognised with the use of corticosteroids and immunosuppressant... Surgery is not thought to be beneficial and in many circumstances can worsen the condition... We recommend that in any significant skin condition, particularly post-operatively or in one not responding to treatment effectively, one must seek the early advice of a dermatologist and not be guided primarily by histology.

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