Pyoderma gangrenosum after breast quadrantectomy with intraoperative radiotherapy

a case report

Abstract

Pyoderma gangrenosum is a rare immune-mediated inflammatory disease of skin, which diagnosis is extremely challenging. The clinical course is the basis for diagnosis, coursing with superficial pustular lesions, erythematous halo, rapid progression to painful ulcerations and unresponsive to antibiotics or surgical interventions, and finally, with immediate improvement with the use of immunosuppressant. The delay in diagnosis can result in numerous hospitalizations and prolonged therapy, and its early recognition, moreover, prevents the progression of these ulcers and its morbidity. There was reported a case of pyoderma gangrenosum that developed after surgery associated with intraoperative radiotherapy in conservative treatment of breast cancer, making up a review of cases reported and their therapeutic possibilities. One may wonder also if the intraoperative radiotherapy would be associated with some immune-mediated stimulus, which could have facilitated the onset of the condition.