In the Department of Plastic and Reconstructive Surgery, University Hospital Brussels, Belgium, Rania Elkhatib, MD, is Attending Physician; Gabriele Giunta, MD, FEBOPRAS, is Consultant; Valerie Hanssens, MSc, is Nurse Specialist; Ayush Kapila, MD, MRCS, is Resident; Randy De Baerdemaeker, MD, FEBOPRAS, is Consultant; Assaf Zeltzer, MD, PhD, is Consultant; and Moustapha Hamdi, MD, PhD, is Head of Department. Acknowledgment: Drs Elkhatib and Giunta contributed equally to this work. The authors have disclosed no financial relationships related to this article. Submitted September 2, 2020; accepted in revised form October 28, 2020; published online ahead of print April 16, 2021.
Adv Skin Wound Care. 2021 Aug 1;34(8):438-443. doi: 10.1097/01.ASW.0000744356.54317.c2.
During the COVID-19 pandemic, an increasing number of patients have been admitted to the ICU with severe respiratory complications requiring prolonged supine positioning. Recently, many case reports have been published regarding dermatologic manifestations associated with COVID-19. However, there is little information about the clinical features of these manifestations. Pyoderma gangrenosum (PG) is an ulcerative noninfectious inflammatory disease of the skin. In at least 50% of the cases, the etiology is unknown. Nevertheless, PG is associated with many systemic diseases. In this article, the authors report two critically ill patients with COVID-19 who developed sacral ulcers during their recovery in the ICU. These ulcers had an atypical course and were exacerbated by surgical debridements. Accordingly, providers suspected PG, which was confirmed by the clinical evolution of the ulcers and biopsies taken from the wounds. To the best of the authors' knowledge, no previous articles have reported sacral pressure injuries associated with PG in patients with COVID-19. Providers should suspect PG in patients with COVID-19 who develop nonhealing pressure injuries.
在 COVID-19 大流行期间，越来越多的患者因严重的呼吸并发症而需要长时间仰卧位，被收入 ICU。最近，有许多关于与 COVID-19 相关的皮肤科表现的病例报告发表。然而，关于这些表现的临床特征的信息却很少。坏疽性脓皮病（PG）是一种溃疡性非传染性皮肤炎症性疾病。在至少 50%的病例中，病因不明。然而，PG 与许多系统性疾病有关。在本文中，作者报告了两名患有 COVID-19 的重症患者，他们在 ICU 康复期间出现了骶部溃疡。这些溃疡的病程不典型，且外科清创术会使其恶化。因此，医生怀疑是 PG，这一点通过溃疡的临床演变和从伤口处取的活检得到了证实。据作者所知，之前没有文章报道过 COVID-19 患者与 PG 相关的骶部压力性损伤。对于出现经久不愈的压力性损伤的 COVID-19 患者，医生应怀疑是 PG。
