[Multilocular pyoderma gangrenosum after uterus resection]

A 71-year-old patient presented with very painful ulcers after uterus-resection with the da Vinci® Surgical System 3 months before. The anamnesis revealed that in the past 10 months similar wounds had appeared after osteosynthesis of a humerus fracture and after breast biopsy. The patient had been unsuccessfully treated with different antibiotics and wound dressings for several months for a suspected superinfected, postoperative disturbed wound healing. None of the wounds became smaller or healed completely. After exclusion of relevant differential diagnoses pyoderma gangrenosum (PG) could be diagnosed and systemic immunosuppressive therapy was initiated. The pain improved rapidly and complete wound healing was achieved. Pyoderma gangrenosum is a rarely diagnosed autoimmune disease which often occurs after physical trauma such as surgical interventions. Because a correct diagnose is usually made late it is important to be aware of this disease to treat it early and correctly.