Journal of Aesthetic & Reconstructive Surgery

Basocellular Carcinoma and Pyoderma Gangrenosum: A Case Report

Pyoderma gangrenosum is a rare acute noninfectious dermatosis. It can develop spontaneously, or be provoked by trauma, and can progress rapidly. The cause of pyoderma gangrenosum is unknown. It is thought to be a variant of vasculitis, and in about 50% of all cases it is associated with internal diseases, like colitis ulcerosa or Morbus Crohn. There is no test available, which can diagnose pyoderma gangrenosum with certainty. A biopsy can be taken, but the diagnosis is ultimately based on the clinical findings. The disease is treated with immunosuppressants, like Prednisone or Cyclosporine.
This case report describes a 61-year old female, who was operated on for multiple basocellular carcinomas of the skin. Four days after the operation, the patient was admitted for a suspected wound infection. Despite multiple debridements and broad-spectrum antibiotics, the wounds progressively deteriorated. The diagnosis pyoderma gangrenosum was considered. A biopsy showed an acute inflammation with abscess formation, which supported the diagnosis. Prednisone therapy was started and the patient recovered completely. This case report shows an unusual example of pyoderma gangrenosum, which to our knowledge has not been described before.

Author(s):

Ed Hartman, Emilie Pfeifle and Frans Koedijk

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