title: Pyoderma gangrenosum in an abdominal surgical site: a case report.
abstract: Pyoderma gangrenosum (PG) is an uncommon, ulcerative skin disease that is often associated with systemic diseases. Herein, we report a development of PG in a surgical site after cholecystectomy that was difficult to discriminate from surgical site infection. The patient was a 74-year-old man who had previously been diagnosed with myelodysplastic syndrome (MDS). Laparoscopic cholecystectomy was planned under diagnosis of cholecystolithiasis, but we converted to open cholecystectomy. The surgical wound was partially erythematous 4 days after surgery. In spite of opening the wound, cleansing it with sterile saline, and administration of antibiotics, inflammation spread with erosion. The clinical manifestations and histopathologic features of biopsy specimen indicated that diagnosis of PG associated with MDS was most likely. Administration of glucocorticoids made a rapid response of skin inflammation. The differential diagnosis of postoperative wound healing complications that were unresponsive to conventional wound local care and antibiotic therapy should include PG, especially in patients with systemic diseases such as MDS.
authors.affiliation: Department of Surgery, Saiseikai Kumamoto Hospital, 5-3-1 Chikami, Munami-ku, Kumamoto, 861-4193, Japan. kenichi0118@gmail.com.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Ogata
authors.affiliation: Department of Surgery, Saiseikai Kumamoto Hospital, 5-3-1 Chikami, Munami-ku, Kumamoto, 861-4193, Japan. takamori60b@gmail.com.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takamori
authors.affiliation: Department of Surgery, Saiseikai Kumamoto Hospital, 5-3-1 Chikami, Munami-ku, Kumamoto, 861-4193, Japan. yoshiaki-ikuta@saiseikaikumamoto.jp.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Ikuta
authors.affiliation: Department of Surgery, Saiseikai Kumamoto Hospital, 5-3-1 Chikami, Munami-ku, Kumamoto, 861-4193, Japan. hideyuki-tanaka@saiseikaikumamoto.jp.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Surgery, Saiseikai Kumamoto Hospital, 5-3-1 Chikami, Munami-ku, Kumamoto, 861-4193, Japan. nobuyuki-ozaki@saiseikaikumamoto.jp.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ozaki
authors.affiliation: Department of Surgery, Saiseikai Kumamoto Hospital, 5-3-1 Chikami, Munami-ku, Kumamoto, 861-4193, Japan. hiromitsu-hayashi@saiseikaikumamoto.jp.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hayashi
authors.affiliation: Department of Surgery, Saiseikai Kumamoto Hospital, 5-3-1 Chikami, Munami-ku, Kumamoto, 861-4193, Japan. katsuhiro-ogawa@saiseikaikumamoto.jp.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Ogawa
authors.affiliation: Department of Surgery, Saiseikai Kumamoto Hospital, 5-3-1 Chikami, Munami-ku, Kumamoto, 861-4193, Japan. kouichi-doi@saiseikaikumamoto.jp.
authors.forename: Koichi
authors.initials: K
authors.lastname: Doi
keywords: Myelodysplastic syndrome; Pyoderma gangrenosum; Surgical site