Pyoderma Gangrenosum Triggered by Acute Ischemia of Lower Extremity: A Case Report

Year 2019, Volume: 21 Issue: 3, 265 - 267, 30.12.2019

Mehmet Kalender , Oğuz Uğur , Hayat Gökmengil Okay Güven Karaca , Meryem İlkay Eren Karanis

https://doi.org/10.18678/dtfd.645577

Abstract

Pyoderma gangrenosum is a very rare condition of unclear etiology with an estimated incidence of 3 to 10 cases per million people per year. We report a case of pyoderma gangrenosum triggered by acute ischemia of lower extremity without a prior history. Seventy-seven years old female patient was admitted to the emergency department with necrosis on the anterior side of her left limb. Digital subtraction arteriography revealed total occlusion of the left common femoral artery for which thrombectomy under local anesthesia was performed successfully. The necrotic area was debrided and biopsies were obtained. Pathological examination revealed pyoderma gangrenosum and steroid treatment was began. The patient was discharged on the 10th postoperative day with prednisone 48 mg per day for the following 30 days. During the management of ischemic peripheral artery disease patients with persistent skin findings, pyoderma gangrenosum should be in the list of differential diagnoses.

Keywords

Pyoderma gangrenosum, risk factors, wound healing

Alt Ekstremitenin Akut İskemisi ile Tetiklenen Pyoderma Gangrenosum: Olgu Sunumu

Abstract

Piyoderma gangrenozum, tahmini insidansı yılda milyon kişi başına 3 ila 10 vaka olan, etiyolojisi açıklanamamış çok nadir görülen bir durumdur. Alt ekstremitenin akut iskemisi ile tetiklenen, daha önce öyküsü olmayan bir pyoderma gangrenozum vakası bildiriyoruz. Yetmiş yedi yaşında kadın hasta acil servise sol alt ekstremite anteriyor yüzde nekrotik yara ile başvurdu. Digital subtraction arteriography ile total tıkalı olduğu saptanan sol ana femoral artere lokal anestezi altında başarılı bir şekilde thrombektomi uygulandı. Nekrotik alan debride edildi ve biyopsiler alındı. Patolojik incelemede pyoderma gangrenozum saptandı ve steroid tedavisi başlandı. Hasta postoperative 10. günde 30 gün boyunca günlük 48 mg prednisone tedavisi ile taburcu edildi. Sebat eden cilt lezyonlu iskemik perifer arter hastalığı olan hastaların tedavisi sırasında, piyoderma gangrenozum ayırıcı tanılar listesinde bulunmalıdır.

Keywords

Piyoderma Gangrenozum, risk faktörleri, yara iyileşmesi

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