Ozkan Omer, Yilmaz Aygen, Ozgentaş H Ege, Artan Reha
Department of Plastic and Reconstructive Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
J Reconstr Microsurg. 2005 Aug;21(6):377-81. doi: 10.1055/s-2005-915205.
Pyoderma gangrenosum is a necrotizing skin disease of unknown etiology. The lesions are painful and occur mostly on the lower extremities, either single or multiple, but can appear in any region of the body. The authors report a case of pyoderma gangrenosum involving bilateral skin lesions over the anterior surface of the legs in a 13-year-old male patient. The lesions presented with ulcerative colitis, which is one of the most commonly associated diseases of pyoderma gangrenosum. After examination, systemic immunosuppressive treatment was administered and the progression of the disease was controlled. The lesions were treated with the simultaneous application of two free anterolateral thigh fasciocutaneous flaps after radical debridement. The procedure was successfully performed and no recurrence was observed. Although microvascular free tissue transfer cannot be performed in a standard fashion in pyoderma gangrenosum cases because of the risk of pathergy response, it should be considered as a surgical option in selected cases, otherwise difficult to manage, with the simultaneous application of appropriate systemic medical treatment.
坏疽性脓皮病是一种病因不明的坏死性皮肤病。皮损疼痛，多发生于下肢，可为单发或多发，但也可出现在身体的任何部位。作者报告了一例13岁男性患者，坏疽性脓皮病累及双侧小腿前侧皮肤病变。皮损伴有溃疡性结肠炎，溃疡性结肠炎是坏疽性脓皮病最常见的相关疾病之一。经检查后，给予全身免疫抑制治疗，病情进展得到控制。在彻底清创后，同时应用两个游离股前外侧筋膜皮瓣对皮损进行治疗。手术成功实施，未观察到复发。尽管由于存在同形反应的风险，在坏疽性脓皮病病例中无法以标准方式进行微血管游离组织移植，但在某些难以处理的特定病例中，应将其视为一种手术选择，并同时应用适当的全身药物治疗。
