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Loose scrotal wound edge approximation in the setting of pyoderma gangrenosum after COVID-19 infection
Mashtura Hasan1,2, Yesul Kim3, Joseph Y Clark2
1Nova Southeastern University College of Allopathic Medicine, Fort Lauderdale, FL, USA.
Abstract:
Pyoderma gangrenosum (PG) is a rare autoinflammatory skin disease characterized by recurrent ulcers. It is a diagnosis of exclusion and treatment can be challenging due to limited evidence-based therapies. While surgical management is typically avoided due to the risk of pathergy, it can be warranted in specific cases. Here, we have illustrated a unique case of genital PG that began after COVID-19 infection and which resulted in scrotal prolapse with testicular exposure. Loose closure with a horizontal mattress suture while the patient was on immunosuppression allowed for complete wound healing.
Insights
Pyoderma gangrenosum (PG) is a rare skin condition. This case report details successful wound healing of genital PG with scrotal prolapse using a simple surgical technique.
Area of Science:
- Dermatology
- Immunology
- Infectious Disease
Background:
- Pyoderma gangrenosum (PG) is a rare, autoinflammatory ulcerative skin condition.
- Diagnosis is often challenging, relying on exclusion, with limited evidence-based treatments.
- Surgical intervention is generally avoided due to pathergy risk but may be necessary.
Observation:
- A unique case of genital pyoderma gangrenosum occurred post-COVID-19 infection.
- The condition progressed to scrotal prolapse, exposing the testicles.
- The patient was managed with immunosuppression.
Findings:
- A novel surgical approach involving loose closure with a horizontal mattress suture was employed.
- This technique facilitated complete wound healing in the affected genital area.
- The patient experienced a favorable outcome without complications.
Implications:
- This case highlights a potential treatment strategy for severe genital PG.
- It suggests that surgical management can be safe and effective in specific PG cases under immunosuppression.
- Further research into surgical interventions for refractory PG is warranted.
