Department of Cardio-Thoracic Surgery, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands.
Department of Dermatology, Medisch Spectrum Twente, Enschede, The Netherlands.
J Card Surg. 2022 Aug;37(8):2419-2422. doi: 10.1111/jocs.16570. Epub 2022 May 6.
Pyoderma gangrenosum (PG) is a rare, chronic inflammatory noninfectious dermatosis. It is associated with underlying systemic or hematological diseases such as myelodysplastic syndrome (MDS) and can be triggered after surgery. Recognition and diagnosis of PG can be difficult as it can mimic a wound infection. Misdiagnosis could lead to invasive procedures which worsen the disease and have possible disastrous aftermath. A 74-year-old male with a history of MDS presents with an atypical sternal wound inflammation. Diagnosis confirmed PG after skin biopsy. No surgical or invasive procedures were performed and the patient was treated on an outpatient basis with prednisolone, clobetasol cream, and cyclosporine. This case shows the importance of a rapid diagnosis of the disease. Awareness is required for the diagnosis of PG in a wound with pronounced livid borders, without improvement after antibiotic treatment or worsening after debridement. Rapid diagnosis and treatment reduce high healthcare costs, morbidity, and mortality.
坏疽性脓皮病（PG）是一种罕见的慢性炎症性非传染性皮肤病。它与骨髓增生异常综合征（MDS）等潜在系统性或血液系统疾病有关，并且可能在手术后发生。由于 PG 可能类似于伤口感染，因此识别和诊断可能具有一定难度。误诊可能导致侵入性手术，从而使疾病恶化，并可能造成灾难性后果。一名 74 岁男性，患有 MDS，表现为胸骨伤口炎症的非典型表现。皮肤活检后确诊为 PG。未进行任何手术或侵入性操作，患者以泼尼松、卤倍他索乳膏和环孢素进行门诊治疗。该病例表明快速诊断疾病的重要性。对于边界明显发绀、抗生素治疗后无改善或清创后恶化的伤口，需要注意 PG 的诊断。快速诊断和治疗可降低高额医疗费用、发病率和死亡率。
