Treatment of Pediatric Pyoderma Gangrenosum With Modified Negative Pressure Wound Therapy and Intralesional Corticosteroids: A Case Report.

BACKGROUND: Pyoderma gangrenosum (PG) is a rare ulcerative skin disease; its etiology is unknown, though it is often associated with autoimmune diseases. Pyoderma gangrenosum results in significant morbidity and exquisite pain that affects health-related quality of life. Wound healing is delayed, an...

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Publicado en:Journal of Wound, Ostomy & Continence Nursing Vol. 49; no. 5; pp. 488 - 492
Autores principales: Barker, Catherine S., Santa Lucia, Gabriella, Brunette, Glenda, Wine Lee, Lara
Formato: case study pictorial Journal Article
Publicado: Lippincott Williams & Wilkins Sep/Oct2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep/Oct2022
      vid: 49
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        atl: Treatment of Pediatric Pyoderma Gangrenosum With Modified Negative Pressure Wound Therapy and Intralesional Corticosteroids: A Case Report.
      aug:
        au:
          Barker, Catherine S.
          Santa Lucia, Gabriella
          Brunette, Glenda
          Wine Lee, Lara
        affil: Catherine S. Barker, BS, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston.
      sug:
        subj:
          Pyoderma Gangrenosum Therapy
          Negative Pressure Wound Therapy
          Adrenal Cortex Hormones Therapeutic Use
          Administration, Topical
          Female
          Adolescence
          Colitis, Ulcerative Surgery
          Ileoanal Reservoir
          Adolescent: 13-18 years
          Female
      ab: BACKGROUND: Pyoderma gangrenosum (PG) is a rare ulcerative skin disease; its etiology is unknown, though it is often associated with autoimmune diseases. Pyoderma gangrenosum results in significant morbidity and exquisite pain that affects health-related quality of life. Wound healing is delayed, and patients often experience relapse. Pyoderma gangrenosum is susceptible to pathergy and deterioration with surgical intervention or other trauma; therefore, treatment includes atraumatic wound care, infection management, and local or systemic immunosuppression. CASE: We describe the use of modified negative pressure wound therapy (NPWT) with intralesional and topical steroids for the treatment of PG in a 15-year-old female patient with ulcerative colitis and a staged J-pouch ileoanal reconstruction. The patient and her family refused all systemic therapy due to prior steroid-associated weight gain. She was unable to tolerate conscious dressing changes, further complicating the treatment plan. Procedural interventions such as NPWT have been used previously for PG; however, they can cause wound pathergy and subsequent wound deterioration. Modified NPWT in conjunction with topical and intralesional steroids induced wound healing without producing pathergy. CONCLUSION: Timely recognition of PG is crucial to appropriate delivery of care. Modified NPWT and localized corticosteroid treatment were key to promoting wound healing in this case of pediatric PG.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        Journal Article
      ougenre: Article
    language: English
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