BACKGROUND. Commonly used treatments for pyoderma gangrenosum are medical,
with immunosuppressive agents employed most often.
OBJECTIVE. TO report a case and discuss the indications for radical surgica
l treatment of pyoderma gangrenosum.
METHODS. Analysis of a case of Crohn's disease-associated pyoderma gangreno
sum treated with immunosuppression followed by amputation, and a review of
the literature on surgical management of pyoderma gangrenosum.
RESULTS. In unstable patients with intractable multiple medical problems, s
urgical treatment of pyoderma gangrenosum may be indicated by the existence
of these life-threatening comorbidities. The recent literature suggests th
at surgical management of pyoderma gangrenosum may also be appropriate in o
ther special circumstances.
CONCLUSIONS. Surgical management, including amputation, may have a role in
the management of pyoderma gangrenosum. Further research is needed to delin
eate precisely the circumstances and patient factors that are appropriate i
ndications for such surgery.