Mixed-aetiology extensive ulcers of the crus: postthrombotic disease and gangrenous pyoderma

Andreev D.Yu.
Chair of Faculty Surgery, State Educational Facility of Higher Professional Education, St. Petersburg State Medical University under the Ministry of Public Health and Social Development of the Russian Federation, St. Petersburg, Russia

Gangrenous pyoderma (GP) is a rare infectious disease typically manifesting itself by utterly painful crural ulcers. Currently, the disease is considered to be most likely of an autoimmune origin.

The author presents herein a case report describing key diagnostic and treatment decisions regarding a 30-year-old woman suffering from extensive crural ulcers. Of special interest was the finding that this patient's ultrasonographic duplex scanning showed the signs corresponding to postthrombotic disease. However, conventional treatment of venous trophic ulcers turned out inefficient. The woman was diagnosed as having GP. Topical therapy with corticosteroid drugs (combined with autodermoplasty and compression therapy) made it possible to achieve complete epithelisation of ulcers.

Thus, should conventional treatment of venous trophic ulcers result in the patient's failure to respond properly, it is necessary to take into consideration the probability of gangrenous pyoderma.

KEY WORDS: gangrenous pyoderma, autodermoplasty, trophic ulcers.

P. 85

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