Fluorescent Imaging as a Component of Diagnosing Pyoderma Gangrenosum: A Case Report.
A 64-year-old White woman was admitted to the hospital with complaint of progressive right hip ulceration at the wound site following a total right hip arthroplasty. Initial history and physical examination gave a leading differential diagnosis of pyoderma gangrenosum. Until recently, the exclusion...
| Published in: | Advances in Skin & Wound Care Vol. 35; no. 6; pp. 1 - 7 |
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| Main Authors: | , , , , , , |
| Format: | case study pictorial Journal Article |
| Published: |
Lippincott Williams & Wilkins
Jun2022
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=157463490&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 157463490 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15277941 38T jtl: Advances in Skin & Wound Care issn: 15277941 maglogo: N pubinfo: dt: Jun2022 vid: 35 iid: 6 pid: 5086 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 157463490 157463490 157463490 10.1097/01.ASW.0000820248.26138.bc 157463490 ppf: 1 ppct: 6 formats: tig: atl: Fluorescent Imaging as a Component of Diagnosing Pyoderma Gangrenosum: A Case Report. aug: au: MacLeod, Brett G. Klarich, Carissa S. Wessman, Laurel L. Gaddis, Kevin J. Konstantinov, Nikifor K. Wubben, Angie Melin, M. Mark affil: At the University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, United States, Brett G. MacLeod, BS, is Medical Student sug: subj: Pyoderma Gangrenosum Diagnosis Fluorescent Dyes Diagnostic Use Diagnostic Imaging Methods Aged Female Hip Arthroplasty, Replacement, Hip Diagnosis, Differential Antiinflammatory Agents Bandages and Dressings Cholecalciferol Antibodies, Monoclonal Negative Pressure Wound Therapy Hypochlorous Acid Pyoderma Gangrenosum Drug Therapy Pyoderma Gangrenosum Therapy Aged: 65+ years Female ab: A 64-year-old White woman was admitted to the hospital with complaint of progressive right hip ulceration at the wound site following a total right hip arthroplasty. Initial history and physical examination gave a leading differential diagnosis of pyoderma gangrenosum. Until recently, the exclusion of infection for pyoderma gangrenosum has been largely clinical and supported by cultures/biopsies demonstrating the absence of infection. The MolecuLight i:X (MolecuLight, Toronto, Ontario, Canada) is a novel bedside fluorescent imaging device capable of determining the bacterial burden within a wound in real time. Fluorescent imaging excluded infection at the initial visit, and debridement was avoided. Subsequently, pathergy was avoided as well. The patient was started on topical clobetasol with hypochlorous acid-soaked dressings. She also received 80 mg daily of prednisone and high-dose vitamin D3 (10,000 IU). Recovery was complicated by a deep tunnel along the incisional line at 3 months postdiagnosis, which required slowing of the prednisone taper and the addition of colchicine. Repeat cultures grew Parvimonas , Pseudomonas , and Streptococcus species. Appropriate antibiotics were given. The patient was transitioned from prednisone to adalimumab and started on negative-pressure wound therapy. Negative-pressure wound therapy was discontinued at 5 months, and the wound resolved at 6 months. pubtype: Academic Journal doctype: case study pictorial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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