"Pyoderma gangrenosum of the breast: A challenging diagnosis".

Pyoderma gangrenosum (PG) of the breast is a rare, ulcerative disease of rapid onset normally associated with systemic disorders and triggered by surgery or trauma. Pyoderma gangrenosum poses a diagnostic challenge. Early diagnosis and appropriate treatment are essential to minimize morbidity and se...

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Publicado en:Breast Journal Vol. 26; no. 11; pp. 2188 - 2194
Autores principales: Cabañas Weisz, Laura M., Vicario Elorduy, Eduardo, García Gutiérrez, Juan José
Formato: case study diagnostic images pictorial research tables/charts Journal Article
Publicado: Wiley-Blackwell Nov2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2020
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/tbj.13984
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        atl: "Pyoderma gangrenosum of the breast: A challenging diagnosis".
      aug:
        au:
          Cabañas Weisz, Laura M.
          Vicario Elorduy, Eduardo
          García Gutiérrez, Juan José
        affil: Department of Plastic Surgery, Cruces University Hospital, Baracaldo, Spain
      sug:
        subj:
          Pyoderma Gangrenosum Diagnosis
          Breast Surgery
          Postoperative Complications
          Early Diagnosis
          Cyclosporine Therapeutic Use
          Treatment Outcomes
          Human
          Retrospective Design
          Histological Techniques
          Biopsy, Needle
          Antibiotics Therapeutic Use
          Adrenal Cortex Hormones Therapeutic Use
          Diagnosis, Delayed
          Immunosuppression
      ab: Pyoderma gangrenosum (PG) of the breast is a rare, ulcerative disease of rapid onset normally associated with systemic disorders and triggered by surgery or trauma. Pyoderma gangrenosum poses a diagnostic challenge. Early diagnosis and appropriate treatment are essential to minimize morbidity and sequelae. We performed a retrospective review of all breast PG cases admitted to Cruces University Hospital over a 5‐year (2015‐2019) period. Medical history, clinical course, and management strategies were assessed. Three patients were analyzed. None of them had previous surgery. No definitive etiology was identified in one case, and the other two were probably biopsy‐driven. Histological findings were reported as nonspecific. Similar skin lesions elsewhere on the body and resistance to wide‐spectrum antibiotic therapy were observed. These features raised awareness on the diagnosis of PG. Ulcerations healed completely within 2 months following treatment with Cyclosporine A or corticosteroid therapy. A complicated late‐diagnosis case that presented with advanced breast and forearm necrosis was managed with steroids followed by trans‐forearm amputation and mastectomy. The breast is an unusual site for PG, but this differential diagnosis should be considered in the presence of breast ulceration. In patients with a strong clinical and histological PG suspicion, we suggest early management with systemic corticosteroids and immunosuppressive therapy prior to any surgical debridement to minimize morbidity and poor esthetic outcomes.
      pubtype: Academic Journal
      doctype:
        case study
        diagnostic images
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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