Pathergy phenomenon: huge pyoderma gangrenosum following tube thoracostomy

Excerpt

A 37-year-old man was referred for the management of right-sided spontaneous tension pneumothorax. He underwent tube thoracostomy that fully re-expanded the right lung. However, the tissue surrounding the tube insertion site became necrotic and extremely painful and progressed to extensive deep ulceration over the next 2 weeks (Fig. 1). Laboratory findings were unremarkable and results of microbiological studies were all negative. A skin biopsy showed neutrophilic dermatosis with a diffuse infiltrate of polymorphonuclear cells, consistent with pyoderma gangrenosum. The patient responded well to a 3-day course of pulse therapy with methylprednisolone and all skin lesions healed completely within 6 months.

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