Post-surgical Pyoderma Gangrenosum Following Elective Aesthetic Procedures: A Case Series of 10 Patients and a Multidisciplinary Treatment Approach

Abstract Post-surgical pyoderma gangrenosum (PPG) is an underdiagnosed variant of a neutrophilic dermatosis that mimics postoperative wound infections, delaying correct diagnosis and treatment. This case series presents 10 female patients who developed PPG following elective aesthetic breast and abdominal surgeries. The average onset of symptoms was 11.4 days postoperatively, with painful ulcerated lesions localized to surgical wounds, often misinterpreted as infection. Diagnosis was primarily clinical and confirmed histologically in 50% of cases. Systemic corticosteroids were the cornerstone of therapy, combined with immunosuppressants in 80% of cases. Hyperbaric oxygen therapy was used in six patients, with excellent clinical response. The average time to clinical resolution was 5.7 months, with no recurrence. Despite successful management, all patients developed unaesthetic scarring. This series reinforces the importance of early suspicion of PPG in atypical postoperative wound evolution and highlights the role of multidisciplinary treatment combining immunosuppression and adjuvant wound care modalities.