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Related Experiment Video

Updated: Jun 4, 2025

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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Pyoderma Gangrenosum: A Nightmare for Breast Surgery-Two Case Reports.

Gülşen Akoğlu1, Murat Demiriz2, Kerim Bora Yılmaz3

  • 1Department of Dermatovenereology, Gülhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey.

European Journal of Breast Health
|January 2, 2025
PubMed
Summary

Pyoderma gangrenosum (PG) is a rare skin condition causing painful ulcers after breast surgery. Early diagnosis and treatment with doxycycline and tacrolimus led to favorable healing in two patients.

Keywords:
Pyoderma gangrenosumbreast surgerydoxycyclinereduction mammoplastytacrolimus

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Area of Science:

  • Dermatology
  • Surgical Oncology
  • Plastic Surgery

Background:

  • Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis presenting as painful ulcers, often misdiagnosed as infections.
  • Postsurgical PG following breast surgery can lead to significant morbidity and disfigurement if not promptly recognized.

Purpose of the Study:

  • To report two cases of postsurgical pyoderma gangrenosum after breast surgery.
  • To highlight the diagnostic challenges and effective management strategies for postsurgical PG.

Main Methods:

  • Case report of two female patients experiencing non-healing ulcers post-breast biopsy and wound dehiscence post-reduction mammoplasty.
  • Initial management included debridements, antibiotics, and wound care, with subsequent diagnosis based on wound progression.
  • Treatment involved oral doxycycline and topical tacrolimus.

Main Results:

  • Both patients initially received ineffective treatments for presumed wound infections.
  • Diagnosis of PG was confirmed by the characteristic increase in wound size and irregularity.
  • Favorable wound healing was achieved within four months with doxycycline and tacrolimus therapy.

Conclusions:

  • Postsurgical pyoderma gangrenosum requires early and accurate diagnosis to prevent misdiagnosis and ineffective treatments.
  • Oral doxycycline and topical tacrolimus represent an effective treatment approach for postsurgical PG.
  • Awareness of PG as a differential diagnosis is crucial for surgeons performing breast procedures.