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坏疽性脓皮病:乳腺手术的噩梦——两例报告

Pyoderma Gangrenosum: A Nightmare for Breast Surgery-Two Case Reports.

作者信息

Akoğlu Gülşen, Demiriz Murat, Yılmaz Kerim Bora

机构信息

Department of Dermatovenereology, Gülhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey.

Department of Pathology, Gülhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey.

出版信息

Eur J Breast Health. 2025 Jan 1;21(1):80-84. doi: 10.4274/ejbh.galenos.2024.2024-7-5.

Abstract

Pyoderma gangrenosum (PG) is a rare, chronic, neutrophilic dermatosis characterized by painful ulcers that are often misdiagnosed as wound infections. We report two cases of postsurgical PG following breast surgery: A 46-year-old woman with a non-healing ulcer after a breast biopsy and a 37-year-old woman with wound dehiscence after bilateral reduction mammoplasty. Both cases were initially managed with repeated debridements, antibiotics, and wound care without improvement. The diagnosis of PG was made based on the increase in wound size and irregularity. Treatment with oral doxycycline and topical tacrolimus led to favorable healing within four months. Breast surgical tehniques, which aim to achieve aesthetic results using intraglandular flaps, have become an important part of clinical practice in breast surgery. Early diagnosis and appropriate management are crucial in postsurgical PG to avoid misdiagnosis and ineffective treatments that cause patient disfigurement.

摘要

坏疽性脓皮病(PG)是一种罕见的慢性嗜中性皮肤病,其特征为疼痛性溃疡,常被误诊为伤口感染。我们报告两例乳房手术后发生的PG病例:一例为46岁女性,乳房活检后出现不愈合溃疡;另一例为37岁女性,双侧乳房缩小成形术后伤口裂开。两例最初均采用反复清创、抗生素治疗及伤口护理,但均无改善。根据伤口大小增加及不规则性做出PG诊断。口服强力霉素和外用他克莫司治疗在四个月内使伤口顺利愈合。旨在使用腺内皮瓣获得美学效果的乳房手术技术已成为乳房手术临床实践的重要组成部分。对于术后PG,早期诊断和恰当处理对于避免误诊及导致患者毁容的无效治疗至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6011/11706121/b3635d0bc0bb/EurJBreastHealth-21-80-figure-1.jpg

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