Case Report Breast

Aesthetic Plastic Surgery

, Volume 36, Issue 6, pp 1347-1352

First online:

Postsurgical Pyoderma Gangrenosum Complicating Reduction Mammaplasty

  • Marcos Artigas GrilloAffiliated withClínica de Cirurgia Plástica Dr. Marcos Grillo, Avenida Sete de Setembro Email author 
  • , Thiego Teixeira CavalheiroAffiliated withDepartment of Infectology, Hospital Nossa Senhora das Graças, Rua Alcides Munhoz
  • , Marcelo da Silva MulazaniAffiliated withDepartment of Infectology, Hospital Nossa Senhora das Graças, Rua Alcides Munhoz
  • , Jaime Luis Lopes RochaAffiliated withDepartment of Infectology, Hospital Nossa Senhora das Graças, Rua Alcides Munhoz
  • , Denise SemchechenAffiliated withDepartment of Infectology, Hospital Nossa Senhora das Graças, Rua Alcides Munhoz
  • , Clovis Arns da CunhaAffiliated withDepartment of Infectology, Hospital Nossa Senhora das Graças, Rua Alcides Munhoz

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Abstract

Reduction mammaplasty is one of the most common surgeries performed by plastic surgeons. It relieves back and neck pain and improves the aesthetic contour of the ptotic breast. Postsurgical pyoderma gangrenosum (PSPG) is an unusual inflammatory disorder leading to rapidly progressive skin necrosis that can occur after any surgical procedure. The skin lesions have the characteristic appearance of ulcers with a purple-colored border and erythematous halo. Clinically, the patient has a low fever and severe local pain. In the majority of cases this disease is misdiagnosed as severe infection leading to improper debridement, exacerbating the problem. The mainstay of therapy for PSPG is still nonoperative and focuses on immunosuppressive medications and local wound care, which allows healing in the majority of the cases. It is important for plastic surgeons and infectologists to be cognizant of this entity, as a delay in diagnosis and management can be life-threatening and lead to considerable tissue loss and disfigurement of the breast. The authors report a case of reduction mammaplasty complicated with PSPG and its treatment.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.

Keywords

Breast reduction Postsurgical pyoderma gangrenosum Pathergy Mammaplasty/adverse effects