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Pyoderma gangrenosum in burned patient: Case report

Obradović-Tomašev Milana (Clinical Center of Vojvodina, Department of Plastic and Reconstructive Surgery, Novi Sad + Faculty of Medicine, Novi Sad)
Jovanović Mladen (Clinical Center of Vojvodina, Department of Plastic and Reconstructive Surgery, Novi Sad + Faculty of Medicine, Novi Sad)
Popović Aleksandra (Clinical Center of Vojvodina, Department of Plastic and Reconstructive Surgery, Novi Sad)

Introduction. Pyoderma gangrenosum is a rare, chronic, destructive, ulcerating skin disease of uncertain etiology. It develops most frequently in patients between 25-45 years of age and affects both sexes equally. Case report. We present a case of pyoderma gangrenosum in a young female patient who sustained a burn injury of 40% total body surface area. She underwent four operations. She developed a wound infection and urinary infection during her hospital stay. By the end of hospitalization, the papules followed with coalesce of ulcerations formed on the previously epithelized areas of her legs. The patient complained of the intensive pain localized on these surfaces. Since pyoderma gangrenosum was suspected, a dermatologist was included in treatment. Therapy was initiated (methylprednisolone 60 mg per day intravenously) with gradual reduction of the dosage. The patient was discharged from hospital two weeks later with almost fully complete cicatrization and epithelization. Conclusion. Pyoderma gangrenosum is still difficult to be diagnosed in the absence of specific and sensitive diagnostic methods; however, it is crucial to be suspected as early as possible and to start treatment immediately. Multidisciplinary approach is essential for optimal results.

Keywords: Pyoderma Gangrenosum, Burns, Wounds and Injuries, Skin Transplantation, Pain, Signs and Symptoms, Therapeutics, Early Diagnosis