[Postoperative necrotizing neutrophilic dermo-hypodermitis of the hand. A diagnosis not to miss]

Pyoderma gangrenosum (PG) is an aseptic ulcerative dermatosis, belonging to the group of neutrophilic dermatoses, and could reveal a systemic blood disorders or inflammatory disease. This dermatosis could mimic rapidly extensive necrotizing dermo-hypodermitis in some clinical aspects. PG can be caused by tissue trauma as in surgical procedure. In this context, this pathology is easily confused with bacterial necrotizing dermo-hypodermitis, the treatment of which gives priority to survival rather than functional outcome, and causes rapid deterioration especially in the upper limb. This case report shows typical evolution of inappropriate treatment of postoperative PG. Faced with postoperative necrotizing dermo-hypodermitis, the diagnosis of PG must be considered, in order to favor good functional outcome.