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Scientific article
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English

Pyoderma gangrenosum after totally implanted central venous access device insertion

Published inWorld journal of surgical oncology, vol. 6, no. 31
Publication date2008
Abstract

BACKGROUND: Pyoderma gangrenosum is an aseptic skin disease. The ulcerative form of pyoderma gangrenosum is characterized by a rapidly progressing painful irregular and undermined bordered necrotic ulcer. The aetiology of pyoderma gangrenosum remains unclear. In about 70% of cases, it is associated with a systemic disorder, most often inflammatory bowel disease, haematological disease or arthritis. In 25-50% of cases, a triggering factor such as recent surgery or trauma is identified. Treatment consists of local and systemic approaches. Systemic steroids are generally used first. If the lesions are refractory, steroids are combined with other immunosuppressive therapy or to antimicrobial agents. CASE PRESENTATION: A 90 years old patient with myelodysplastic syndrome, seeking regular transfusions required totally implanted central venous access device (Port-a-Cath(R)) insertion. Fever and inflammatory skin reaction at the site of insertion developed on the seventh post-operative day, requiring the device's explanation. A rapid progression of the skin lesions evolved into a circular skin necrosis. Intravenous steroid treatment stopped the necrosis' progression. CONCLUSION: Early diagnosis remains the most important step to the successful treatment of pyoderma gangrenosum.

Keywords
  • Aged : 80 and over
  • Catheterization : Central Venous
  • Catheters : Indwelling
  • Humans
  • Immunosuppressive Agents
  • Male
  • Myelodysplastic Syndromes
  • Pyoderma Gangrenosum
Citation (ISO format)
INAN, Ihsan et al. Pyoderma gangrenosum after totally implanted central venous access device insertion. In: World journal of surgical oncology, 2008, vol. 6, n° 31. doi: 10.1186/1477-7819-6-31
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ISSN of the journal1477-7819
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