Pyoderma Gangrenosum Triggered by COVID-19 Vaccination in a Patient with Ulcerative Colitis: A Case Report.

Pyoderma gangrenosum (PG) is a rare inflammatory skin disease that is difficult to diagnose. PG may be an extra-intestinal manifestation of ulcerative colitis (UC). In recent times, coronavirus disease (COVID-19) vaccines have caused various adverse cutaneous reactions. However, to the best our know...

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Publicado en:International Journal of Lower Extremity Wounds Vol. 24; no. 4; pp. 1239 - 1244
Autores principales: Kim, Yoon-Chung, Shim, Hyung Sup, Jeong, Howon, Park, Yune-Jung
Formato: case study pictorial Journal Article
Publicado: Sage Publications Inc. Dec2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2025
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      pub: Sage Publications Inc.
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        atl: Pyoderma Gangrenosum Triggered by COVID-19 Vaccination in a Patient with Ulcerative Colitis: A Case Report.
      aug:
        au:
          Kim, Yoon-Chung
          Shim, Hyung Sup
          Jeong, Howon
          Park, Yune-Jung
        affil: Department of Orthopaedic Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
      sug:
        subj:
          Pyoderma Gangrenosum Chemically Induced
          Pyoderma Gangrenosum Surgery
          COVID-19 Vaccines Adverse Effects
          Colitis, Ulcerative
          Adult
          Female
          Grafts
          Physical Examination
          Magnetic Resonance Imaging Methods
          Foot Pathology
          Debridement
          Pyoderma Gangrenosum Drug Therapy
          Antibiotics Therapeutic Use
          Adrenal Cortex Hormones Therapeutic Use
          Anticoagulants
          Negative Pressure Wound Therapy
          Treatment Outcomes
          Adult: 19-44 years
          Female
      ab: Pyoderma gangrenosum (PG) is a rare inflammatory skin disease that is difficult to diagnose. PG may be an extra-intestinal manifestation of ulcerative colitis (UC). In recent times, coronavirus disease (COVID-19) vaccines have caused various adverse cutaneous reactions. However, to the best our knowledge, combinations thereof have not been reported. We encountered a case of PG triggered by COVID-19 vaccination in a patient with UC. A 40-year-old woman developed severe pain and an abscess in the dorsum of the left foot after receiving the first dose of the messenger RNA (mRNA)-based Pfizer/BioNTech BNT162b2 COVID-19 vaccine. Severe painful ulcers with purulent necrosis and gaseous gangrene progressed rapidly along the extensor tendons and muscles to the toes and ankle. Although surgical debridement can worsen PG by triggering pathergy, we nonetheless performed wide debridement including partial extensor tenotomy with abscess drainage to prevent progression to pyogenic ankle arthritis and to rescue the toes. Antibiotics, corticosteroids, and anticoagulants were prescribed during surgical wound management via negative pressure therapy. After the lesion improved, the skin and soft tissue defect were covered using a superficial circumflex iliac artery perforator free flap and a split-thickness skin graft. The patient was satisfied with the foot salvage, and could walk unaided (without a brace or cane) from 8 weeks after the final surgery. PG may be rare even in UC patients, but mRNA-based COVID-19 vaccines may find an immunosuppressive niche. A high level of caution and suspicion of skin manifestations after vaccination is essential.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        Journal Article
      ougenre: Article
    language: English
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