Nakajima N, Ikeuchi M, Izumi M, Kuriyama M, Nakajima H, Tani T
Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, 185-1 Oko-cho Kohasu, Nankoku 783-8505, Japan.
Knee. 2011 Dec;18(6):453-5. doi: 10.1016/j.knee.2010.06.005. Epub 2010 Jul 18.
Pyoderma gangrenosum is a rare ulcerative disorder of the skin of unknown etiology. We present a case of pyoderma gangrenosum that occurred following total knee arthroplasty, which was initially misdiagnosed as severe wound infection. Repeated debridement procedures resulted in a large soft tissue defect around the anterior knee joint. The patient was treated successfully with a latissimus dorsi musculocutaneous flap under immunosuppressive therapy. Pyoderma gangrenosum is often misdiagnosed as an infected wound, but the treatment for theses differential diagnoses is completely different. When a lesion is refractory to thorough treatment for infection, a diagnosis of pyoderma gangrenosum should be considered.
坏疽性脓皮病是一种病因不明的罕见皮肤溃疡性疾病。我们报告一例全膝关节置换术后发生的坏疽性脓皮病，最初被误诊为严重伤口感染。反复清创导致膝关节前方出现大面积软组织缺损。患者在免疫抑制治疗下采用背阔肌肌皮瓣成功治愈。坏疽性脓皮病常被误诊为感染性伤口，但这些鉴别诊断的治疗方法完全不同。当病变对感染的彻底治疗无效时，应考虑坏疽性脓皮病的诊断。
