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Postsurgical Pyoderma Gangrenosum After Autologous Breast Reconstruction

Case Report and Review of the Literature

Momeni, Arash MD*; Satterwhite, Thomas MD*; Eggleston, John M. III MD

doi: 10.1097/SAP.0b013e318296b7ae
Breast Surgery
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Pyoderma gangrenosum (PG) is a rare skin disorder of unknown etiology that is believed to be part of the spectrum of neutrophilic dermatoses. Although 25% to 50% of cases are idiopathic, PG is associated with systemic disease in up to 70% of patients, most notably inflammatory bowel disease, rheumatoid arthritis, and paraproteinemia. Although a multitude of PG cases after breast reduction have been reported, only recently has an association of PG with breast reconstruction been acknowledged. In the present article, the case of postsurgical PG (PSPG) after autologous breast reconstruction is presented along with a review of the literature. The importance of early diagnosis and initiation of appropriate treatment is discussed. The authors discuss the possibility that the increased number of breast reconstructions being performed may increase the incidence of PSPG cases seen by plastic surgeons. As such, it is critical to remove PSPG from the list of “exotic” diseases and place it higher on the list of differential diagnoses as delays in treatment can result in debilitating complications with substantial patient morbidity.

From the *Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford; and †Department of Plastic Surgery, Kaiser Permanente Santa Clara Medical Center, Santa Clara, CA.

Received March 16, 2013, and accepted for publication, after revision, April 11, 2013.

Conflicts of interest and sources of funding: none declared.

Reprints: Arash Momeni, MD, Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, 770 Welch Rd, Suite 400 Palo Alto, CA. E-mail: amomeni@stanford.edu.

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