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Post Reconstruction Breast Pyoderma Gangrenosum: Early Recognition and Prosthesis Salvage.

Cicuto B, Cheriyan T, Rudnicki P, Guo L - Plast Reconstr Surg Glob Open (2015)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic Surgery, Lahey Hospital and Medical Center, Tufts University, School of Medicine, Boston, Mass.

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.

No MeSH data available.


Related in: MedlinePlus

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.
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Figure 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.

Mentions: On POD 9, the patient presented to the emergency department with chest discomfort and increasing erythema of the right breast associated with expanded area of superficial ulcerations. She was admitted for presumed cellulitis and intravenous antibiotics were administered. Progression of the ulcerations was noted despite systemic antibiotic therapy. Based on previous experience and the appearance of dermal yellow pustules within the ulcerations (Fig. 1), a diagnosis of PG was suspected. The patient was started on oral prednisolone (1 mg/kg/d), and subsequent lack of progression with notable improvement in appearance of the ulcerations strongly suggested a diagnosis of PG.


Post Reconstruction Breast Pyoderma Gangrenosum: Early Recognition and Prosthesis Salvage.

Cicuto B, Cheriyan T, Rudnicki P, Guo L - Plast Reconstr Surg Glob Open (2015)

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.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4494504&req=5

Figure 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.
Mentions: On POD 9, the patient presented to the emergency department with chest discomfort and increasing erythema of the right breast associated with expanded area of superficial ulcerations. She was admitted for presumed cellulitis and intravenous antibiotics were administered. Progression of the ulcerations was noted despite systemic antibiotic therapy. Based on previous experience and the appearance of dermal yellow pustules within the ulcerations (Fig. 1), a diagnosis of PG was suspected. The patient was started on oral prednisolone (1 mg/kg/d), and subsequent lack of progression with notable improvement in appearance of the ulcerations strongly suggested a diagnosis of PG.

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic Surgery, Lahey Hospital and Medical Center, Tufts University, School of Medicine, Boston, Mass.

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.

No MeSH data available.


Related in: MedlinePlus