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Necrotizing Dermatosis of the Arm Following Cubital Tunnel Release: Pyoderma Gangrenosum, the Great Mimic

A Case Report

Utrillas-Compaired, Alfonso, MD, PhD1; Jeavons, Richard Paul, MD, FRCS(Eng)2; Viana-López, Ramón, MD1; González-Gómez, Ignacio, MD1

doi: 10.2106/JBJS.CC.N.00193
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Disclosures

Case: We report the case of a fifty-one-year-old woman who underwent an uneventful cubital tunnel release and was admitted five days after surgery with a diagnosis of infection. Despite multiple surgical debridements and prolonged intravenous antibiotic treatment, the wound edges continued to slough and necrose. A delayed diagnosis of postsurgical pyoderma gangrenosum (PG) was made, and corticosteroid and immunosuppressive treatment was administered, with immediate clinical improvement.

Conclusion: When apparent postoperative infections fail to improve with debridement and antimicrobial treatment, and when accompanied by a fever and severe local pain, nonspecific histopathological findings, and negative microbiological cultures, postsurgical PG should be considered.

1Orthopaedics and Traumatology Department, Guadalajara University Hospital, C/Donante de Sangre s/n, 19002 Guadalajara, Spain. E-mail address for A. Utrillas-Compaired: osnofla2001@yahoo.com

2Orthopaedics and Traumatology Department, James Cook University Hospital, Marton Road, Middlesbrough TS43BW, United Kingdom

Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated
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