جستجوی مقالات مرتبط با کلیدواژه « pyoderma gangrenosum » در نشریات گروه « پزشکی »

Hemodynamic changes are one of the most important risk factors for complications in rhinoplasty. The aim of this study was to compare the effect of remifentanil and nitroglycerin on intraoperative blood pressure and other complications during and after rhinoplasty in surgical center.

This was a quasi-experimental double-blind study performed on patients referred to Imam Ali Clinic of Shahrekord University of Medical Sciences, Iran, for rhinoplasty in year 2017. 50 rhinoplasty candidates with class one and two American Society of Anesthesiologists (ASA) were randomly divided into two groups of 25. Simultaneously, with the administration of anesthesia in the first group, remifentanil (0.1-0.3 μg/kg/minute) and in the second group, nitroglycerin (0.5-1 μg/kg/minute) were administered. During the surgery, heart rate, bleeding, systolic and diastolic blood pressure, were recorded. Moreover, the amount and degree of ecchymosis and edema were determined.

There was no significant difference between the two groups in terms of duration of surgery, bleeding during surgery, mean heart rate, ecchymosis, edema, and diastolic blood pressure at different times. Mean heart rate and diastolic blood pressure at different time were not significantly different between the two groups, too. But, the amount of reducing in systolic blood pressure at 5 minutes in remifentanil group (17.64 ± 14.39 mmHg) was significantly lower than nitroglycerin group (25.60 ± 7.09 mmHg).

The results indicate similar function of remifentanil and nitroglycerin in reducing intraoperative bleeding and complications during and after rhinoplasty surgery.

Pyoderma gangrenosum (PG) of the breast is a rare that present as a painful ulcer on the skin. It usually affects people in their 20s to 50s and occurs in both men and women. Typically, PG affects the legs in adults. In children, it may affect the legs, buttocks, head, and neck. Pyoderma gangrenosum is characterized by a papule, nodule, or pustule that progresses to an injured lesion with unknown boundaries. In this study, a case of Pyoderma gangrenosum is introduced after breast surgery.A 38-year-old woman with a 3 cm wound in the right breast area that has gradually grown has been examined for exudative bloody discharge for the past 2 weeks. Two weeks after breast surgery, a three-centimeter progressive wound has formed on the surface of the breast, which gradually grew larger. During treatment, several oral and injectable antibiotics were prescribed that have not been effective in healing the wound. A biopsy lesion was reported in which a non-specific skin lesion with hyperplasia and vesicle formation without malignancy was reported. The patient had no gastrointestinal symptoms. Infliximab was started and continued for the patient.

In the differential diagnosis of resistant skin wounds, especially in the leg area, and in this case in the breast the diagnosis of pyoderma gangrenosome should always be considered.
Even if the patient has no history of inflammatory bowel disease, pyoderma gangrenosum may occur before intestinal manifestations.

Pyoderma gangrenosum (PG) (ulcerating neutrophilic dermatosis) is a rare disease that about of half of these patients have a systemic disorder, particularly Crohn's and ulcerative colitis. In addition, inflammatory lesions play key role in its pathogenesis. In early diagnosis of disease, we will further prevent of serious consequences of the disease. In this report, a case of PG after the vaginal surgery with history of ulcerative colitis was introduced.
A 37-years old woman was admitted in an University Hospital of Mashhad University of Medical Sciences, Iran, in 2016 two weeks after genital surgery. The chief complaints were fever, painful tenderness, ulcerative lesion and inflammatory papule on surgical site and thigh. She suffered of fever despite received oral and then wide spectrum intravenous antibiotic therapy. Blood cultures and wound culture were negative. In addition to two deferent intravenous antibiotics, topical wound debridement was performed. Despite this course of treatment which did not improve the lesion, biopsy was performed. Histopathology features of biopsy specimen indicated prominent neutrophils mixed inflammation and lymphocytic vasculitis indicated as pyoderma gangrenous. The patient's medical history included associated ulcerative colitis from 18 years ago and she was under irregular oral receiving of Asacol (mesalamine). Intravenous corticosteroid therapy was administered which led to response of skin of right thigh and surgical site inflammation. After 6-months follow-up, the patient is still in good condition.
Based on major variable clinical manifestations and no diagnostic serologic test of pyoderma gangrenosum, diagnosis of this disease is difficult. Increased awareness about PG and exclusion of other etiologies such as inflammatory and immunologic disease will aid in prompting of pyoderma gangrenosum diagnosis and proper management of the disease.

A 79-year-old female came to skin clinic with an ulcer, 15×20 cm, on her left shin. The laboratory report and both the skin and bone marrow biopsies reports, showed pyoderma gangrenosum associated with multiple myeloma. The patient was referred to hematology clinic for treatment. Multiple myeloma has rarely been associated with pyoderma gangrenosum. Multiple myeloma should be investigated in patients with paraproteinemia and pyoderma gangrenosum.

Pyoderma gangrenosum is characterized by a chronic, non-infectious, destructive ulcer which is mostly seen on distal lower extremities, but it can be found anywhere on body. We report an 18-year old man who developed keloids after healing of his ulcers. He was a known case of chronic relapsing pyoderma gangrenosum. His previous ulcers were used to heal leaving atrophic, cigarette-paper scars. But since a year ago, following using clofazimine for his disease, he has developed keloids after healing the ulcers. Alterations in the immune system of the patient might be involved. Development of keloids in ulcers of pyoderma gangrenosum has not been reported previously.