Procianoy Fernando, Barbato Mariana Tremel, Osowski Luiz Eduardo, Bocaccio Francisco José de Lima, Bakos Lucio
Setor de Trauma e Plástica Ocular, Serviço de Oftalmologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
Arq Bras Oftalmol. 2009 May-Jun;72(3):384-6. doi: 10.1590/s0004-27492009000300020.
A 19 year old female with pyoderma gangrenosum was referred to the oculoplastic clinic for evaluation of severe cicatricial ectropion of the right lower eyelid. Examination evidenced important scarring of lower eyelid and malar region with secondary ectropion. A full-thickness skin graft associated with a lateral tarsal strip procedure and scar tissue release was performed. The patient's corticosteroid dose was raised for the procedure, and after surgery there was no healing problem or ulcer formation in the eyelid or in the graft donor site. As pyoderma gangrenosum is associated with a pathergy phenomenon in up to 25% of the cases, the onset of new lesions is a relevant concern when performing surgery in these patients. In this case, the surgery was safely performed under corticosteroid immunosuppression.
一名患有坏疽性脓皮病的19岁女性被转诊被转诊至眼部整形门诊，以评估右下眼睑严重瘢痕性睑外翻。检查发现下眼睑和颧部有明显瘢痕并继发睑外翻。进行了全厚皮片移植联合外侧睑板条手术及瘢痕组织松解。手术过程中增加了患者的皮质类固醇剂量，术后眼睑及植皮供区均未出现愈合问题或溃疡形成。由于高达25%的坏疽性脓皮病病例伴有同形反应现象，因此在这些患者进行手术时，新病变的出现是一个重要问题。在本病例中，手术在皮质类固醇免疫抑制下安全进行。
