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Pyoderma gangrenosum complicating bilateral total knee arthroplasty
Samer Attar1, Mark J Spangehl, William J Casey
1Department of Orthopedics, Johns Hopkins Hospital, Baltimore, Maryland, USA. sattar@uchicago.edu
Orthopedics
|September 2, 2010
Summary
Pyoderma gangrenosum, a rare ulcerative skin condition, can mimic infections after surgery. Early diagnosis and steroid treatment are crucial for healing, avoiding unnecessary procedures.
Area of Science:
- Dermatology
- Surgical Pathology
Background:
- Pyoderma gangrenosum is an ulcerative, necrotic dermatosis of unknown cause.
- It is often linked to systemic inflammatory, hematologic, or neoplastic conditions.
Observation:
- A patient developed bilateral knee wound dehiscence and ulceration post-total knee arthroplasty.
- The condition worsened despite surgical debridements and antibiotics, with negative deep intraoperative cultures.
Findings:
- Diagnosis of pyoderma gangrenosum was confirmed.
- Treatment with corticosteroids led to significant improvement.
Implications:
- Consider pyoderma gangrenosum in culture-negative, non-healing surgical wounds.
- Misdiagnosis can lead to delayed treatment and iatrogenic worsening of this inflammatory condition.
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