TOPICAL THERAPY IN THE MANAGEMENT OF CLASSIC PYODERMA GANGRENOSUM WITH MULTIPLE LESIONS: A CASE REPORT

Elaine Cristina Salzedas Muniz; Lina Monetta; Shaiane Cecília da Silva

Todos os Trabalhos

Trabalho

Título do Trabalho

TOPICAL THERAPY IN THE MANAGEMENT OF CLASSIC PYODERMA GANGRENOSUM WITH MULTIPLE LESIONS: A CASE REPORT

Autores

Elaine Cristina Salzedas Muniz
Lina Monetta
Shaiane Cecília da Silva

Modalidade

Regras de Submissão

Área temática

Relato de caso de grande relevância científica / Case report of great scientific relevance

Data de Publicação

22/07/2025

País da Publicação

Brasil

Idioma da Publicação

Inglês

Página do Trabalho

https://www.even3.com.br/anais/sgawcm2025/1132619-topical-therapy-in-the-management-of-classic-pyoderma-gangrenosum-with-multiple-lesions--a-case-report

ISBN

978-65-272-1566-0

Palavras-Chave

pyoderma gangrenosum; wound healing; wounds and Injuries; patient care planning

Resumo

Objective: To describe the topical therapy approach used in the management of wounds caused by classic pyoderma gangrenosum. Method: Observational case report following the CARE Guidelines, ensuring transparency and quality in clinical reporting. The case includes initial assessment (symptoms, physical exam, medical history, diagnostics), therapeutic interventions (type and description), follow-up, and clinical outcomes (effectiveness, adherence, adverse events, and discharge). Results: A 36-year-old female patient reported a brown spider bite in June 2022, leading to necrosis. In October 2022, biopsies of five lesions (three on the right leg, two on the left) confirmed pyoderma gangrenosum. She had no prior infection but had a history of substance use and psoriasis. Living abroad without support, she returned to Brazil in June 2023. New biopsies and cultures tested positive for Burkholderia cepacia. She began care at a wound reference center on June 23, 2023, with topical therapy, hyperbaric oxygen, and systemic medications (antibiotics, tramadol, morphine, dipyrone). Pain control was poor, prompting the introduction of cannabidiol and upadacitinib in July. Initial wound assessment showed granulation tissue, crusts, slough, purulent-bloody exudate, moderate odor, detached edges, perilesional erythema, and warmth. Pain score: 8/10. Cleansing used polyhexamethylene biguanide, followed by a non-adherent mesh with essential fatty acids and silver, plus activated charcoal with silver to manage exudate and odor. To avoid trauma, the mesh was used for seven days. As the wound evolved, dressings transitioned to hydrofiber and polyurethane foam, always with non-adherent interfaces (mesh or dermal matrix). Silver-based dressings were prioritized. Dressings continued until full epithelialization in September 2023. A silicone dressing was recommended post-discharge to protect the scar and support aesthetic healing. Nursing care was comprehensive: guidance on medication use, hygiene, rest, nutrition, and adaptation to daily life. The team educated both the patient and her family on the importance of multidisciplinary follow-up, especially given the risk of pathergy. Conclusion: Classic pyoderma gangrenosum is a rare, painful, and fast-progressing neutrophilic dermatosis with scarce evidence-based guidance, particularly for topical care. In this case, combining targeted topical treatment, systemic drugs, hyperbaric oxygen, and multidisciplinary education led to complete wound healing and improved quality of life. The case highlights the need for specific clinical protocols and further research on topical therapies in pyoderma gangrenosum.

Título do Evento: SGAWCm2025
Cidade do Evento: São Paulo
Título dos Anais do Evento: Anais SGAWCm: Sobratafe Global Advanced Wound Care Meeting
Nome da Editora: Even3
Meio de Divulgação: Meio Digital

Como citar

MUNIZ, Elaine Cristina Salzedas; MONETTA, Lina; SILVA, Shaiane Cecília da. TOPICAL THERAPY IN THE MANAGEMENT OF CLASSIC PYODERMA GANGRENOSUM WITH MULTIPLE LESIONS: A CASE REPORT.. In: Anais SGAWCm: Sobratafe Global Advanced Wound Care Meeting. Anais...Sao Paulo(SP) Centro de Convenções Rebouças, 2025. Disponível em: https//www.even3.com.br/anais/sgawcm2025/1132619-TOPICAL-THERAPY-IN-THE-MANAGEMENT-OF-CLASSIC-PYODERMA-GANGRENOSUM-WITH-MULTIPLE-LESIONS--A-CASE-REPORT. Acesso em: 15/12/2025