A rare case of pyoderma gangrenosum occurring at the site of laparoscopic port following laparoscopic radical nephrectomy

Takuto Ogasawara, Fumimasa Fukuta, Miri Fujita, Hitoshi Tachiki, Tetsuya Shindo,Junji Kato,Hisashi Uhara,Naoya Masumori

IJU Case Reports(2022)

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Abstract
Introduction:Pyoderma gangrenosum is a rare dermatological disease associated with underlying inflammatory conditions.Case presentation:A 59-year-old man was diagnosed with right renal cancer cT1aN0M0 and laparoscopic right radical nephrectomy was performed. Five days after surgery, he had a high-grade fever, surgical site flare, and severe pain. At first, we diagnosed surgical site infection and wound dehiscence. Despite treatment for infection, his general condition and dermatological symptoms did not improve. Thereafter, a dermatologist advised us to perform a skin biopsy and blood culture examinations. Finally, the man was diagnosed with pyoderma gangrenosum according to the pathology of the skin biopsy and negative blood culture. After both intravenous administration of predonisolone and a topical corticosteroid, the high-grade fever and dermatological symptoms improved greatly.Conclusion:Although pyoderma gangrenosum is a rare disease, we should bear in mind the disease since the treatment strategy is completely different from that for surgical site infection.
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Key words
pyoderma gangrenosum,laparoscopic port
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