Development of Postsurgical Pyoderma Gangrenosum with New Keloid after Keloid Resection.

Keloids are a dermal fibroproliferative disorder and can arise from trauma, acne, vaccination, and herpes zoster. Pyoderma gangrenosum (PG) is a painful ulcerative skin disorder that is associated with neutrophilic dysfunction. However, the pathophysiologies of keloids and PG are not fully understoo...

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Published in:Advances in Skin & Wound Care Vol. 37; no. 9; pp. 499 - 503
Main Authors: Yusaku Saijo, Hiroaki Kuwahara, Keigo Ito, Rei Ogawa, Satoshi Akaishi
Format: case study pictorial tables/charts Journal Article
Published: Lippincott Williams & Wilkins Sep2024
Online Access:View this record in EBSCOhost
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      jtl: Advances in Skin & Wound Care
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      dt: Sep2024
      vid: 37
      iid: 9
      pid: 5086
      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        atl: Development of Postsurgical Pyoderma Gangrenosum with New Keloid after Keloid Resection.
      aug:
        au:
          Yusaku Saijo
          Hiroaki Kuwahara
          Keigo Ito
          Rei Ogawa
          Satoshi Akaishi
        affil: Plastic Surgeon, Department of Plastic and Reconstructive Surgery, Nippon Medical School Hospital, Tokyo
      sug:
        subj:
          Pyoderma Gangrenosum Surgery
          Postoperative Complications
          Pyoderma
          Keloid Surgery
          Recurrence
          Wound Care
          Female
          Adult
          Keloid Physiopathology
          Adalimumab Therapeutic Use
          Adrenal Cortex Hormones Administration and Dosage
          Taping and Strapping
          Wound Healing
          Biopsy
          Adult: 19-44 years
          Female
      ab: Keloids are a dermal fibroproliferative disorder and can arise from trauma, acne, vaccination, and herpes zoster. Pyoderma gangrenosum (PG) is a painful ulcerative skin disorder that is associated with neutrophilic dysfunction. However, the pathophysiologies of keloids and PG are not fully understood. The authors encountered an unusual case of a 24-year-old woman who presented with an anterior chest keloid that bore an ulcer. The keloid was resected along with the ulcer, and histology revealed the ulcer to be a neutrophilic PG ulcer. A year after surgery, another ulcer developed in the scar. The ulcer met the PARACELSUS criteria of a postsurgical PG ulcer. After treatment with systemic prednisone and adalimumab for 250 days, the ulcer re-epithelialized. However, relapsed keloids were then observed at the PG site. Corticosteroid taping may be the safest therapy for patients with a history of PG. Conversely, if there is suspicion that a patient is prone to keloid development, diagnostic biopsies and surgical management of PG ulcers should be avoided or conducted with care.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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