Fong Chun Wa, Bento Manuel, Fang Feng Jun, Pang Fong Kuong, Lio Io Hang, Tong Sut Sin, Hao Chou Kuan
Department of Plastic and Reconstructive Surgery, Centro Hospitalar Conde São Januário, Estrada do Visconde de S. Januário, Macau SAR.
JPRAS Open. 2022 Jul 6;33:139-144. doi: 10.1016/j.jpra.2022.06.008. eCollection 2022 Sep.
Pyoderma gangrenosum (PG) is a rare neutrophilic inflammatory skin disease. Systemic corticosteroid and immunosuppressive agents are the mainstay treatment. PG usually precludes a surgical approach due to pathergy phenomenon. Recent literatures show skin grafting and negative pressure wound therapy are safe if performed under adequate immunosuppression. We present a case of a 61-year-old male patient suffered from PG induced left posterior leg wound with Achilles tendon exposure. We made timely diagnosis and treated him with adequate immunosuppression therapy followed by perforator propeller flap for wound coverage. This case report emphasizes the need for high index of suspicion for PG diagnosis. Furthermore, with adequate immunosuppression, operative intervention may not be an absolute contraindication for PG.
坏疽性脓皮病（PG）是一种罕见的嗜中性粒细胞性炎症性皮肤病。全身用皮质类固醇和免疫抑制剂是主要治疗方法。由于同形反应现象，PG通常不采用手术方法。最近的文献表明，如果在充分的免疫抑制下进行，皮肤移植和负压伤口治疗是安全的。我们报告一例61岁男性患者，患有PG导致左小腿后部伤口，跟腱外露。我们及时做出诊断，并对他进行了充分的免疫抑制治疗，随后采用穿支螺旋桨皮瓣覆盖伤口。本病例报告强调了对PG诊断要有高度怀疑指数的必要性。此外，在充分的免疫抑制下，手术干预可能不是PG的绝对禁忌证。
