title: Successful treatment of wound breakdown caused by pyoderma gangrenosum after total knee arthroplasty.
abstract: Pyoderma gangrenosum is a rare ulcerative disorder of the skin of unknown etiology. We present a case of pyoderma gangrenosum that occurred following total knee arthroplasty, which was initially misdiagnosed as severe wound infection. Repeated debridement procedures resulted in a large soft tissue defect around the anterior knee joint. The patient was treated successfully with a latissimus dorsi musculocutaneous flap under immunosuppressive therapy. Pyoderma gangrenosum is often misdiagnosed as an infected wound, but the treatment for theses differential diagnoses is completely different. When a lesion is refractory to thorough treatment for infection, a diagnosis of pyoderma gangrenosum should be considered.
authors.affiliation: Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, 185-1 Oko-cho Kohasu, Nankoku 783-8505, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Nakajima
authors.forename: M
authors.initials: M
authors.lastname: Ikeuchi
authors.forename: M
authors.initials: M
authors.lastname: Izumi
authors.forename: M
authors.initials: M
authors.lastname: Kuriyama
authors.forename: H
authors.initials: H
authors.lastname: Nakajima
authors.forename: T
authors.initials: T
authors.lastname: Tani
mesh_terms: D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D016572:Cyclosporine / Q000627:therapeutic use*; D003646:Debridement; D062109:Dermatologic Surgical Procedures; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007719:Knee Joint / Q000473:pathology / Q000601:surgery; D011239:Prednisolone / Q000627:therapeutic use*; D017511:Pyoderma Gangrenosum / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D012867:Skin / Q000473:pathology; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone