RESEARCH ARTICLE


Pyoderma Gangrenosum Following the Revision of a Breast Reconstruction and Abdominoplasty



Mio Nakamura*, 1, Amir M. Ghaznavi2, Vigen Darian2, Aamir Siddiqui2
1 Wayne State University School of Medicine, Detroit, MI, USA
2 Division of Plastic and Reconstructive Surgery, Department of Surgery, Henry Ford Health System Detroit, MI, USA


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© Nakamura et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Wayne State University School of Medicine, 540 E. Canfield St., Detroit, MI 48201, USA; Tel: 313-577-1463; Fax: 313-577-0361; E-mail: mnakamur@med.wayne.edu


Abstract

Pyoderma gangrenosum (PG) is a rare ulcerative dermatologic disease and little is known about its etiology and pathogenesis. Recent reports show that there have been limited but increasing number of cases of PG following aesthetic surgeries. Post-surgical PG is often misdiagnosed, which can have serious clinical consequences. The following case report describes a young woman who underwent a cosmetic breast augmentation and abdominoplasty which was complicated by post-operative necrotizing fasciitis. She was presented one year later for surgical correction of her acquired breast and abdominal deformities. Post-operatively she developed a severe inflammatory skin response presumed to be a wound infection. However, after repeated surgical debridements, the wounds persisted without a defined bacterial or fungal organism. After clinical exclusion of all other etiologies, PG was diagnosed and confirmed with histopathology. The patient was subsequently treated with aggressive immunosuppressive therapy, and the lesions resolved without any signs of residual PG. This case report attempts to increase awareness for the rare post-surgical complication of PG in aesthetic surgery and to improve future diagnosis and management of such cases.

Keywords: Abdominoplasty, breast reconstruction, neutrophilic dermatoses, post-operative complication, pyoderma gangrenosum, wound complication.