Department of Orthopaedics, Yonemori Hospital, Ryokusenkai Group, Kagoshima, Japan.
Department of Dermatology, Takada Hospital, Gyokushoukai Group, Kagoshima, Japan.
JBJS Case Connect. 2021 Apr 20;11(2):01709767-202106000-00041. doi: e20.00924.
A 69-year-old woman with myelodysplastic syndrome-related pancytopenia was administered granulocyte colony-stimulating factor (G-CSF) before total hip arthroplasty to prevent postoperative infection. One week postoperatively, she developed peri-incisional ecchymosis and associated leukocytosis. Over the next few weeks, surgical site infection was suspected; however, dermatologist evaluation and subsequent biopsy supported a diagnosis of pyoderma gangrenosum, which resolved after prompt steroid administration.
Postoperative pyoderma gangrenosum should be included in the differential diagnosis when considerable postoperative ecchymosis and leukocytosis occur, particularly after preoperative G-CSF administration.
一位 69 岁女性患有骨髓增生异常综合征相关全血细胞减少症，在全髋关节置换术前接受了粒细胞集落刺激因子（G-CSF）治疗，以预防术后感染。术后一周，她出现切口周围瘀斑和白细胞增多。在接下来的几周里，怀疑发生了手术部位感染；然而，皮肤科医生的评估和随后的活检支持了坏疽性脓皮病的诊断，在迅速给予类固醇治疗后得到了缓解。
当术后出现大量瘀斑和白细胞增多，尤其是在术前接受 G-CSF 治疗后，应将术后坏疽性脓皮病纳入鉴别诊断。
