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Wong WW, Machado GR, Hill ME. Pyoderma Gangrenosum: The Great Pretender and a Challenging Diagnosis. J Cutan Med Surg 2011; 15:322-8. [DOI: 10.2310/7750.2011.10119] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: The initial presentation of pyoderma gangrenosum (PG) is virtually indistinguishable from a pyogenic infection, making debridement appear necessary. However, operative approaches often lead to exacerbation and rapid extension through pathergy. Objective and Methods: In attempts to increase awareness of this condition and minimize misdiagnoses, a review of published reports involving PG of the hand and digits was performed and included 35 patients in addition to our case of a 14-year-old female with a history of ulcerative colitis. Results: Of the total cases, 29 patients were misdiagnosed as having an infection and subsequently treated with antibiotics; 13 of these patients also had debridement of their lesions. Twenty-eight patients had associated medical conditions, including ulcerative colitis, Crohn disease, diabetes mellitus, and cancer. Conclusion: When approached with a rapidly growing ulcerated lesion that does not respond to operative therapy, the possibility of PG should be entertained and a high-dose corticosteroid regimen and/or immunomodulator therapy implemented.
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Affiliation(s)
- Wendy W. Wong
- From the Department of Plastic Surgery, Loma Linda University, Loma Linda University Children's Hospital, Loma Linda, CA
| | - Gustavo R. Machado
- From the Department of Plastic Surgery, Loma Linda University, Loma Linda University Children's Hospital, Loma Linda, CA
| | - Michael E. Hill
- From the Department of Plastic Surgery, Loma Linda University, Loma Linda University Children's Hospital, Loma Linda, CA
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Ehling A, Karrer S, Klebl F, Schäffler A, Müller-Ladner U. Therapeutic management of pyoderma gangrenosum. ACTA ACUST UNITED AC 2004; 50:3076-84. [PMID: 15476233 DOI: 10.1002/art.20559] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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