Perioperative management of pyoderma gangrenosum.

Pyoderma gangrenosum (PG) classically presents with an acute inflammatory stage, characterized by rapid evolution of painful ulcerations. The pathergy associated with PG lesions complicates disease management. Although PG is commonly treated with immunosuppression, some patients have refractory noni...

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Publicado en:Journal of the American Academy of Dermatology Vol. 83; no. 2; pp. 369 - 375
Autores principales: Haag, Carter K., Bacik, Lindsay, Latour, Emile, Morse, Daniel C., Fett, Nicole M., Ortega-Loayza, Alex G.
Formato: research Journal Article
Publicado: Elsevier B.V. Aug2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2020
      vid: 83
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      pub: Elsevier B.V.
      place: New York, New York
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        10.1016/j.jaad.2020.01.002
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        atl: Perioperative management of pyoderma gangrenosum.
      aug:
        au:
          Haag, Carter K.
          Bacik, Lindsay
          Latour, Emile
          Morse, Daniel C.
          Fett, Nicole M.
          Ortega-Loayza, Alex G.
        affil: Department of Dermatology, Oregon Health & Science University, Center for Health & Healing, Portland, Oregon
      sug:
        subj:
          Recurrence Prevention and Control
          Surgery, Operative Methods
          Perioperative Care Methods
          Pyoderma Gangrenosum Surgery
          Treatment Outcomes
          Recurrence
          Scales
          Human
      ab: Pyoderma gangrenosum (PG) classically presents with an acute inflammatory stage, characterized by rapid evolution of painful ulcerations. The pathergy associated with PG lesions complicates disease management. Although PG is commonly treated with immunosuppression, some patients have refractory noninflammatory ulcers. In this subpopulation, there are case reports of successful surgical treatment. However, there is no consensus on optimal perioperative treatment for patients with PG undergoing surgery of any kind, PG related or otherwise. Therefore, we conducted a comprehensive literature review describing perioperative management practices and risk factors that may predict response to surgical intervention. We identified 126 cases of surgical intervention in patients with active PG; among these, only 16.7% experienced postoperative disease progression. No perioperative treatments or clinical risk factors were identified as statistically significant predictors of disease recurrence. Although limited by case series design and publication bias, this study is a valuable means of hypothesis generation for this rare condition.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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