Refractory postsurgical pyoderma gangrenosum in a patient with Beckwith Wiedemann syndrome: response to multimodal therapy.
Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis that may be difficult to diagnose and treat. We presented a 41-year-old woman who required skin grafting following third-degree burns to her left breast. She suffered recurrent graft dehiscence and infections over many years, prompting elec...
| Publicado en: | BMJ Case Reports pp. 1 - 5 |
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| Autores principales: | , , , , |
| Formato: | case study pictorial Journal Article |
| Publicado: |
BMJ Publishing Group
Oct2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104116316&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104116316 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1757790X B755 jtl: BMJ Case Reports issn: 1757790X maglogo: N pubinfo: dt: Oct2013 pid: 8280 pub: BMJ Publishing Group artinfo: ui: 104116316 91950888 10.1136/bcr-2013-201084 104116316 ppf: 1 ppct: 4 formats: tig: atl: Refractory postsurgical pyoderma gangrenosum in a patient with Beckwith Wiedemann syndrome: response to multimodal therapy. aug: au: Fakhar, Faiza Memon, Sehrish Deitz, Diane Abramowitz, Richard Alpert, Deborah R. affil: Department of Internal Medicine, Jersey Shore University Medical Center, Neptune, New Jersey, USA sug: subj: Beckwith-Wiedemann Syndrome Diagnosis Combined Modality Therapy Pyoderma Gangrenosum Therapy Treatment Outcomes Breast Reconstruction Adverse Effects Female Adult Staining and Labeling Diagnosis, Differential Adult: 19-44 years Female ab: Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis that may be difficult to diagnose and treat. We presented a 41-year-old woman who required skin grafting following third-degree burns to her left breast. She suffered recurrent graft dehiscence and infections over many years, prompting elective bilateral reduction mammoplasty. She subsequently developed suture margin ulcerations unresponsive to topical therapies and antibiotics. Skin biopsies were non-specific, and a clinical diagnosis of PG was established. Although initially responsive to corticosteroids, wounds promptly recurred following steroid taper. She was treated unsuccessfully with various immunomodulatory agents and underwent elective bilateral mastectomy. Following a mastectomy, she developed progressive deep chest wall ulcerations. She failed numerous immunomodulatory treatments, surgical wound closure and negative pressure wound therapy. Ultimately, treatment with adalimumab, mycophenolate mofetil and prednisone, in addition to hyperbaric oxygen therapy facilitated progressive healing. Our case highlights the role of collaborative multimodal therapy for the treatment of refractory PG. pubtype: Academic Journal doctype: case study pictorial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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