01 September 2022>: Articles
Pyoderma Gangrenosum Mimicking Necrotizing Fasciitis on Magnetic Resonance Imaging: A Case Report and Literature Review
Unknown etiology, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Unexpected drug reaction, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)
Sungwoo Park B , Hyoshim Shin C , Dong Hyun Lee D , Eun-Ha Koh E , Jeong-Hee Lee D , Gyeong-Won Lee A*DOI: 10.12659/AJCR.931734
Am J Case Rep 2022; 23:e931734
Table 1. Literature review of magnetic resonance imaging and histology of pyoderma gangrenosum.
Author | Age/sex | Initial diagnosis | MRI finding | Histology | Treatment and outcome |
---|---|---|---|---|---|
Lee []14 | 47/M | Diabetic foot infection | Cellulitis with myositis but no assertive abscess pocket | Neutrophilic infiltrate in whole field with absence of squamous carcinoma or other malignancy | |
Yoshida []15 | 67/M | Pyoderma gangrenosum and sterile osteomyelitis | Low intensity with T1-weighted phase and high intensity with T2-weighted phase in the sternum and the overlying fat and skin tissues, indicating severe inflammation | Epidermal ulceration with prominent infiltration of neutrophils | |
Fonder []16 | 38/F | Pyoderma gangrenosum | Superficial T2 bright signal compatible with inflammation involving the subcutaneous tissue down to the level of the deep fascia | Necrosis, a mixed inflammatory infiltrate, and a small-vessel leukocytoclastic vasculitis | |
Jain []17 | 70/F | Cellulitis | Wound present medially in the distal calf with adjacent skin thickening along with circumferential subcutaneous edema | Severe acute cellulitis, abscess formation, and granulation tissue | |
Milind []18 | 49/M | Disseminated tuberculosis | Small fluid collection adjacent to right ischial tuberosity suggesting an infective etiology | Perivascular lymphocytic infiltration with endothelial swelling and focal neutrophilic abscess | |
Husain []19 | 55/M | Ulcerative colitis | A complex appearing, peripherally enhancing fluid collection within the subcutaneous tissues overlying the lateral aspect of the distal fibular metadiaphysis, associated with extensive subcutaneous edema extending along the lateral part of the distal leg and ankle in conjunction with mild cortical thickening and/or chronic periostitis of the distal tibia and fibula | Diffuse neutrophilic infiltrates throughout the dermis | |
Park [this case] | 67/F | Necrotizing fasciitis | High signal intensity in the left lower leg fascia and subcutaneous fat layer | Diffuse acute inflammation in the dermis with an ulcer and neutrophilic infiltration is apparent in the histopathological examination of the skin lesion | |
MRI – magnetic resonance imaging. |