Pyoderma Gangrenosum After Hand Surgery: A Case Report

Introduction. Pyoderma gangrenosum (PG) is a rare, neutrophilic dermatosis that can be triggered after minor trauma or surgery and mimics a fulminating infection. It is commonly associated with a systemic disease, such as inflammatory bowel disease, metabolic syndrome, rheumatologic or hematological disorders, and malignancies. The typical clinical appearance is hemorrhagic nodules, which rapidly progress into extremely painful, irregular, red to violaceous ulceration with undermined border and purulent necrotic bases. The treatment of PG is nonsurgical. Unnecessary surgical procedures may incite a pathergic response, worsening the disease dramatically and potentially resulting in a limb amputation. Case Report. A report of PG, originally misdiagnosed as an infection after a carpal tunnel release, is presented. Conclusions. This case emphasizes the importance of early recognition of PG to provide a timely diagnosis and avoid unnecessary surgeries, which can result in devastating consequences.