Pyoderma gangrenosum

Abstract

Abstract:

Introduction: Pyoderma Gangrenosum is an inflammatory disease, which is characterized by skin ulcers that tend to be painful and are usually related to autoimmune diseases or neoplasms, but also on rare occasions may appear independently of such disorders. (1)

The diagnosis is made by biopsy and histopathology and in relation to treatment, anti-inflammatory drugs, immunosuppressant’s and specifically in the care of the wounds produced are used.

We present the clinical case of a 40-year-old female patient who came for evaluation to the Hospital de Gamboa Santa Casa de Misericordia in Rio de Janeiro, Brazil. With a painful ulcer of 6 months of evolution, which was performed incisional biopsy reaching the diagnosis of Pyoderma Gangrenosum. The patient was treated with Prednisone, colchicine and healing with complete resolution. The patient continues taking colchicine up to the present date. It was decided to publish this case because in the hospital environment of Rio de Janeiro these cases are not often seen.

The patient was admitted for presenting an ulcer at the lower limb level, due to the geographical location of the ulcer, there are several diagnostic hypotheses, after performing complementary examinations and after evaluation by medical specialists, it was concluded that the patient presented a picture of Pyoderma Gangrenosum, for which cures were started twice a week, tissuebiopsies were taken and days later oral systemic treatment was started.

Approximately 6 months after the treatment was started, the patient had a 95% recovery and to date she must continue to be evaluated to see the
progress of the ulcer.

Objectives: To provide information on Pyoderma Gangrenosum in terms of diagnosis, treatment, prognosis and how the following case was managed at the Hospital de Gamboa Santa Casa de Misericordia in Rio de Janeiro.

Materials and Methods: A descriptive investigation of the aforementioned patient’s case is carried out, in which a chronology of events is kept with photographic data for a better understanding,
a field investigation by being in contact and carrying out the continuous follow-up of the patient, in addition we have a documentary investigation, as we have relevant information of the case which was extracted from the Clinical History.

Results: As for the results, it is important to mention the multidisciplinary approach that this type of pathologies must have, it is of vital importance to rigorously evaluate the wound, in order to have a good treatment with total recovery of the patient, in the case of the patient mentioned above, given the good therapeutic approach that was obtained despite the large surface that covers the wound and the time in which the patient was delayed in attending, tissue recovery was
evidenced around 95% with an excellent prognosis.
Conclusions: It has been shown that when a good clinical history is taken together with a correct evaluation of the wound, it is possible to opt for a treatment that significantly improves the characteristics of the lesion, in addition to the
systemic discomfort that the patient may have, in this case the best option for the therapeutic approach of this patient was local treatment with daily cures which helped us to promote the healing processes of the skin, and systemic treatment which was changed according to the requirements in relation to the appearance of complications that occurred during the whole process. The recovery rate was 95%. This indicates that treatments for Pyoderma Gangrenosum should be versatile and adjusted to the new needs of the wound.