{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:21:21Z","timestamp":1772583681912,"version":"3.50.1"},"reference-count":36,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T00:00:00Z","timestamp":1719532800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Pyoderma gangrenosum (PG) is a rare, autoimmune skin condition characterized by painful, rapidly progressing ulcers, often associated with autoimmune dysregulation. Managing PG following breast surgery presents unique challenges due to its pathergy phenomenon, which complicates surgical interventions. This article outlines the case of PG in a 48-year-old female post-breast surgery and reviews management strategies through a systematic analysis of the literature. Methods: A systematic literature review from 2018 to 2023 identified 24 relevant articles on PG management post-breast surgery. The studies were analyzed to compare the efficacy and complications of conservative versus combined (conservative and surgical) treatment strategies. Results: Results indicate that while conservative management, primarily with corticosteroids, remains preferred, combined strategies, including systemic therapies, vacuum-assisted closure, and surgery, offer significant benefits in select cases. Conclusions: Our findings suggest that a personalized, multifaceted treatment plan is crucial for managing PG effectively, emphasizing the need for early detection, meticulous planning, and comprehensive care to optimize patient outcomes.<\/jats:p>","DOI":"10.3390\/jcm13133800","type":"journal-article","created":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T06:51:53Z","timestamp":1719557513000},"page":"3800","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Pyoderma Gangrenosum Post-Breast Surgery: A Case Report and Comprehensive Review of Management Strategies"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7079-1106","authenticated-orcid":false,"given":"Ioan Constantin","family":"Pop","sequence":"first","affiliation":[{"name":"Plastic Surgery Department, \u201cProf. Dr. I Chiricuta\u201d Institute of Oncology, 400015 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radu Alexandru","family":"Ilies","sequence":"additional","affiliation":[{"name":"Plastic Surgery Department, \u201cProf. Dr. I Chiricuta\u201d Institute of Oncology, 400015 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corina","family":"Baican","sequence":"additional","affiliation":[{"name":"Dermatology Department, County Emergency Hospital, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6112-0223","authenticated-orcid":false,"given":"Stefan","family":"Strilciuc","sequence":"additional","affiliation":[{"name":"Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"},{"name":"RoNeuro Institute for Neurological Research and Diagnostic, 400337 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentin","family":"Muntean","sequence":"additional","affiliation":[{"name":"General Surgery Department, Humanitas Clinical Hospital, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian","family":"Muntean","sequence":"additional","affiliation":[{"name":"Plastic Surgery Department, \u201cProf. Dr. I Chiricuta\u201d Institute of Oncology, 400015 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1038\/s41572-020-0213-x","article-title":"Pyoderma Gangrenosum","volume":"6","author":"Maverakis","year":"2020","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_2","first-page":"224","article-title":"Pyoderma Gangrenosum\u2014A Guide to Diagnosis and Management","volume":"19","author":"George","year":"2019","journal-title":"Clin. Med. J. R. Coll. Physicians Lond."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1007\/s00266-015-0499-3","article-title":"Aesthetic Breast Augmentation Mastopexy Followed by Post-Surgical Pyoderma Gangrenosum (PSPG): Clinic, Treatment, and Review of the Literature","volume":"39","author":"Larcher","year":"2015","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1080\/1744666X.2018.1438269","article-title":"Pyoderma Gangrenosum: A Review of Pathogenesis and Treatment","volume":"14","author":"Ahn","year":"2018","journal-title":"Expert Rev. Clin. Immunol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1111\/j.1468-3083.2009.03199.x","article-title":"Pyoderma Gangrenosum: An Updated Review","volume":"23","author":"Ruocco","year":"2009","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1007\/s40257-017-0251-7","article-title":"Pyoderma Gangrenosum: An Update on Pathophysiology, Diagnosis and Treatment","volume":"18","author":"Alavi","year":"2017","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1111\/j.1365-4632.2004.02128.x","article-title":"Pyoderma Gangrenosum: Clinicopathologic Correlation and Proposed Diagnostic Criteria","volume":"43","author":"Su","year":"2004","journal-title":"Int. J. Dermatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.bjps.2014.12.036","article-title":"A Systematic Review of Post-Surgical Pyoderma Gangrenosum: Identification of Risk Factors and Proposed Management Strategy","volume":"68","author":"Zuo","year":"2015","journal-title":"J. Plast. Reconstr. Aesthetic Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1016\/j.mayocp.2016.05.001","article-title":"Postoperative Pyoderma Gangrenosum: A Clinical Review of Published Cases","volume":"91","author":"Tolkachjov","year":"2016","journal-title":"Mayo Clin. Proc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e1072","DOI":"10.1097\/GOX.0000000000001072","article-title":"Successful Treatment of Pyoderma Gangrenosum after Augmentation Mastopexy Using Vacuum Therapy","volume":"4","author":"Soncini","year":"2016","journal-title":"Plast. Reconstr. Surg. Glob. Open"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"24e","DOI":"10.1097\/01.prs.0000200776.13868.02","article-title":"Managing Pyoderma Gangrenosum: A Synergistic Approach Combining Surgical D\u00e9bridement, Vacuum-Assisted Closure, and Hyperbaric Oxygen Therapy","volume":"117","author":"Niezgoda","year":"2006","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1097\/SAP.0000000000001782","article-title":"Pyoderma Gangrenosum after Abdominal Free Tissue Transfer for Breast Reconstruction: Case Series and Management Guidelines","volume":"83","author":"Li","year":"2019","journal-title":"Ann. Plast. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"409","DOI":"10.4048\/jbc.2021.24.e25","article-title":"Pyoderma Gangrenosum Mimicking Wound Infection after Breast Cancer Surgery","volume":"24","author":"Kim","year":"2021","journal-title":"J. Breast Cancer"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"234","DOI":"10.4103\/JCAS.JCAS_98_17","article-title":"Is Prophylactic Immunosuppressive Therapy for Patients with a History of Postsurgical Pyoderma Gangrenosum Necessary?","volume":"11","author":"Canzoneri","year":"2018","journal-title":"J. Cutan. Aesthetic Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1097\/SAP.0000000000002101","article-title":"A Deceptive Diagnosis: Pyoderma Gangrenosum After Breast Surgery-A Case Series and Literature Review","volume":"83","author":"Mella","year":"2019","journal-title":"Ann. Plast. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1159\/000509745","article-title":"Postsurgical Pyoderma Gangrenosum in a Breast Cancer Patient: A Case Report and Literature Review","volume":"14","author":"Vernaci","year":"2021","journal-title":"Case Rep. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"331","DOI":"10.4274\/ejbh.galenos.2023.2023-6-1","article-title":"A Rare Complication Following Breast Conserving Surgery: Pyoderma Gangrenosum","volume":"19","author":"Costa","year":"2023","journal-title":"Eur. J. Breast Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1177\/14782715221126768","article-title":"Negative-Pressure Wound Therapy as an Adjunct to Treating Pyoderma Gangrenosum","volume":"52","author":"Mulholland","year":"2022","journal-title":"J. R. Coll. Physicians Edinb."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"E67","DOI":"10.25270\/wnds\/2021.e6774","article-title":"Management of Postsurgical Pyoderma Gangrenosum Following Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Role for a Dermal Regeneration Template","volume":"33","author":"Ramamurthi","year":"2021","journal-title":"Wounds Compend. Clin. Res. Pract."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"E4111","DOI":"10.1097\/GOX.0000000000004111","article-title":"Pyoderma Gangrenosum after Breast Cancer Resection: A Less-Invasive and Early Treatment Using the Skin around Ulcers","volume":"10","author":"Hirai","year":"2022","journal-title":"Plast. Reconstr. Surg.-Glob. Open"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/jscr\/rjy299","article-title":"A Rare Skin Condition Masquerading as a Serious Wound Infection","volume":"2018","author":"Rogers","year":"2018","journal-title":"J. Surg. Case Rep."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"E89","DOI":"10.1111\/ans.15316","article-title":"Post-Surgical Pyoderma Gangrenosum of the Breast: A Diagnostic Dilemma?","volume":"90","author":"Solis","year":"2020","journal-title":"ANZ J. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1007\/s12282-018-00940-5","article-title":"Post-Surgical Pyoderma Gangrenosum of the Breast: Needs for Early Diagnosis and Right Therapy","volume":"26","author":"Guaitoli","year":"2019","journal-title":"Breast Cancer"},{"key":"ref_24","first-page":"e3223","article-title":"Pyoderma Gangrenosum after Fat Grafting in Alloplastic Breast Reconstruction: An Unusual Outcome","volume":"8","author":"Song","year":"2020","journal-title":"Plast. Reconstr. Surg.-Glob. Open"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1111\/tbj.14242","article-title":"Post-Surgical Pyoderma Gangrenosum in Otherwise Healthy Patient with History of COVID-19","volume":"27","author":"Rich","year":"2021","journal-title":"Breast J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2032","DOI":"10.1007\/s00266-020-01899-5","article-title":"Postsurgical Pyoderma Gangrenosum After Breast Surgery: A Plea for Early Suspicion, Diagnosis, and Treatment","volume":"44","author":"Hammond","year":"2020","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2188","DOI":"10.1111\/tbj.13984","article-title":"Pyoderma Gangrenosum of the Breast: A Challenging Diagnosis","volume":"26","year":"2020","journal-title":"Breast J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1136\/bcr-2018-228243","article-title":"Pyoderma Gangrenosum of the Breast","volume":"11","author":"Tomoda","year":"2018","journal-title":"BMJ Case Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3005","DOI":"10.1007\/s00266-021-02362-9","article-title":"Dermatologic Complications Following Cosmetic and Reconstructive Plastic Surgery: A Systematic Review of the Literature","volume":"45","author":"Nicksic","year":"2021","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_30","first-page":"e11432","article-title":"Post Reduction Mammaplasty Pyoderma Gangrenosum: An Unusual Presentation of a Misdiagnosed Entity","volume":"12","year":"2020","journal-title":"Cureus"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/dth.12774","article-title":"Efficacy and Safety of Etanercept for Postoperative Pyoderma Gangrenosum after Infliximab Serum Sickness","volume":"32","author":"Ariane","year":"2019","journal-title":"Dermatol. Ther."},{"key":"ref_32","first-page":"35","article-title":"Pyoderma Gangrenosum Associated with Ulcerative Colitis","volume":"14","author":"Rados","year":"2006","journal-title":"Acta Dermatovenerol. Croat. ADC"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1089\/sur.2021.307","article-title":"Pyoderma Gangrenosum as Differential Diagnosis to Post-Operative Infection after Breast Plastic Surgery","volume":"23","author":"Coste","year":"2022","journal-title":"Surg. Infect."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1111\/tbj.13253","article-title":"Breast Pyoderma Gangrenosum: A Rare Postoperative Complication of Antiphospholipid Antibody Syndrome","volume":"25","author":"Figurelli","year":"2019","journal-title":"Breast J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"E4282","DOI":"10.1097\/GOX.0000000000004282","article-title":"The Management of Postsurgical Pyoderma Gangrenosum Following Breast Surgery","volume":"10","author":"Edinger","year":"2022","journal-title":"Plast. Reconstr. Surg.-Glob. Open"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.jaad.2020.01.002","article-title":"Perioperative Management of Pyoderma Gangrenosum","volume":"83","author":"Haag","year":"2020","journal-title":"J. Am. Acad. Dermatol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/13\/3800\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:06:54Z","timestamp":1760108814000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/13\/3800"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,28]]},"references-count":36,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["jcm13133800"],"URL":"https:\/\/doi.org\/10.3390\/jcm13133800","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,28]]}}}