Jain A, Nanchahal J, Bunker C
Departments of Plastic and Reconstructive Surgery, Dermatology, Imperial College School of Medicine, Charing Cross Hospital Campus, London, UK.
Br J Plast Surg. 2000 Jul;53(5):437-40. doi: 10.1054/bjps.2000.3351.
Pyoderma gangrenosum is a destructive cutaneous disease characterised by progressive painful ulceration. The occurrence of pyoderma gangrenosum at a surgical site is rare (especially if there is no predisposing illness), but is well recognised. We present a case of a 63-year-old man who developed erythematous ulcerative lesions due to pyoderma gangrenosum in and around a lower limb fasciocutaneous flap used to cover an exposed total knee prosthesis. The lesions were initially confused with postoperative wound infection. No predisposing disorder, other than the rarely reported association with osteoarthritis, was found. The diagnosis is important because its rapid detection not only avoids unnecessary treatment but also allows for prompt intervention with oral steroids. This case is presented to alert surgeons to the presence of pyoderma gangrenosum and its diagnostic confusion with postoperative wound infection.
坏疽性脓皮病是一种以进行性疼痛性溃疡为特征的破坏性皮肤疾病。坏疽性脓皮病在手术部位发生较为罕见（尤其是在没有易感疾病的情况下），但已得到充分认识。我们报告一例63岁男性病例，该患者在用于覆盖暴露的全膝关节假体的下肢筋膜皮瓣及其周围出现了因坏疽性脓皮病引起的红斑性溃疡性病变。这些病变最初被误诊为术后伤口感染。除了很少报道的与骨关节炎的关联外，未发现其他易感疾病。该诊断很重要，因为其快速检测不仅可以避免不必要的治疗，还能及时采用口服类固醇进行干预。本文报告此病例是为了提醒外科医生注意坏疽性脓皮病的存在及其与术后伤口感染的诊断混淆。
