Article Text
Summary
We report a man who underwent autologous stem cell transplantation (ASCT) for multiple myeloma. Two months after ASCT, he presented with necrotising cholecystitis due to gallbladder stones and was submitted to laparoscopic cholecystectomy. About a week later, he developed progressive skin ulcers at sites where trochanters had been inserted. Progressive enlargement and necrotic aspect of these ulcers took place despite debridement and large spectrum antibiotics. New ulcers developed at the site of enoxaparin injection at the right arm (pathergy phenomenon). A skin biopsy and clinical evaluation favoured the diagnosis of pyoderma gangrenosum (PG). He was treated with daily methylprednisolone and dapsone with improvement of the lesions. This is the first case in the literature of PG after ASCT. Despite the risk factors, the onset of an autoinflammatory disease right after the transplant is intriguing since PG is extremely rare in immunocompromised patients.
- dermatology
- malignant and benign haematology
- haematology (drugs and medicines)
- malignant disease and immunosuppression
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Footnotes
Contributors MJA and MCBB prepared the manuscript draft and revised the literature with important intellectual input from SFC. After preparation, the manuscript was revised by EMX. All authors approved the final manuscript. All authors also were actively involved in the care of the patient. EMX conducted prehaematopoietic stem cell transplantation evaluation. MJA, MCBB and SFC participated in the management of the patient’s complications during his laparoscopic cholecystectomy.
Competing interests None declared.
Patient consent Next of kin consent obtained.
Provenance and peer review Not commissioned; externally peer reviewed.