Pyoderma gangrenosum after breast surgery: A systematic review.

Area of Science:

• Dermatology
• Surgical Pathology

Background:

• Post-surgical pyoderma gangrenosum (PSPG) is a rare inflammatory skin disorder with unknown causes.
• Diagnosis is challenging due to its similarity to wound infections and lack of specific diagnostic markers.
• This review aimed to identify factors contributing to PSPG for improved diagnosis and therapy.

Purpose of the Study:

• To systematically review the literature on PSPG following breast surgery.
• To identify factors aiding in the timely diagnosis of PSPG.
• To inform appropriate therapeutic strategies for PSPG.

Main Methods:

• A systematic literature review following PRISMA guidelines.
• Searched PubMed, Medline, EMBASE, Scopus, Cochrane, and Google Scholar.
• Focused on PSPG cases after reconstructive and aesthetic breast surgery.

Main Results:

• 87 cases of PSPG after breast surgery were identified in 68 articles.
• Most common post-surgery types: breast reduction (44%) and microsurgical reconstruction (16%).
• Associated conditions: malignancies (37%), autoimmune deficiencies (17%). Negative cultures in 90%. Median diagnostic delay: 12.5 days; treatment delay: 20.0 days. Common treatments: steroids (84%), Cyclosporine A (22%).

Conclusions:

• Diagnosing PSPG remains difficult.
• Distinct clinical signs combined with poor treatment response warrant further investigation.
• Timely diagnosis and correct treatment are crucial for this debilitating condition.