Wong Lulu L, Borda Luis J, Liem Timothy, Keller Jesse J, Ortega-Loayza Alex G, Jung Enjae
University of Miami Miller School of Medicine, Miami, FL, USA.
Oregon Health & Science University, Portland, OR, USA.
Int J Low Extrem Wounds. 2023 Jun;22(2):418-422. doi: 10.1177/15347346211002334. Epub 2021 Apr 29.
Ulcers of mixed etiology are diagnostically elusive and challenging to treat, especially when rare conditions are superimposed. Pyoderma gangrenosum (PG) is an autoinflammatory, ulcerative skin disease that is difficult to diagnose. Diagnostic criteria exist but there are no specific clinical tests to identify it. We discuss a case of PG initially diagnosed as venous ulcer in the setting of peripheral artery disease, complicated by superinfection, refractory to standard wound care, multiple surgical debridements, revascularization, negative pressure therapy, and parenteral antibiotics. Findings differentiating PG from other wound etiologies are explored, with the aim of improving clinical recognition of this condition.
病因混合的溃疡在诊断上难以捉摸且治疗具有挑战性，尤其是当罕见病症叠加时。坏疽性脓皮病（PG）是一种自身炎症性溃疡性皮肤病，难以诊断。虽然存在诊断标准，但尚无特异性临床检查来识别它。我们讨论了一例最初在周围动脉疾病背景下被诊断为静脉溃疡的PG病例，该病例并发了感染，对标准伤口护理、多次手术清创、血管重建、负压治疗和肠外抗生素治疗均无效。探讨了将PG与其他伤口病因相鉴别的发现，旨在提高对这种病症的临床认识。
