4.4 Article

Pyoderma Gangrenosum Following Breast Reduction: Treatment With Topical Tacrolimus and Steroids

Journal

AESTHETIC SURGERY JOURNAL
Volume 34, Issue 3, Pages 394-399

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1177/1090820X13520448

Keywords

breast reduction; pyoderma gangrenosum; topical tacrolimus; necrotizing soft tissue infection; autoimmune; debridement

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Pyoderma gangrenosum (PG) is a rare, noninfectious, inflammatory dermatosis usually associated with autoimmune disorders. Wounds may mimic a necrotizing infection, and the diagnosis is usually made after antibiotic therapy fails. Debridement may cause even larger wounds because of pathergy, so PG treatment consists of corticosteroids and local wound care. Pyoderma gangrenosum can be a devastating complication of breast and aesthetic surgery. We describe a case of PG following unilateral breast reduction that resulted in systemic inflammatory response; after treatment with prednisone and topical tacrolimus, the PG was resolved. The application of topical tacrolimus may reduce the need for prolonged corticosteroids. Level of Evidence: 5

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