Cyclosporine and prednisone perioperative regimen prevents pyoderma gangrenosum recurrence after breast reconstruction.

Pyoderma gangrenosum (PG) is a rare, severe neutrophilic dermatosis characterized by rapidly enlarging, painful ulcers, often triggered by trauma or surgery. Its exact etiology remains unclear, but it is frequently associated with systemic inflammatory conditions like inflammatory bowel disease (e.g., ulcerative colitis, Crohn's disease). Current standard-of-care for PG focuses on immunosuppression to manage active lesions, but preventing recurrence, especially in patients requiring subsequent surgical procedures, presents a significant clinical challenge. The unpredictable nature of PG and its potential for rapid progression necessitate effective prophylactic strategies to improve patient outcomes and minimize morbidity. This case highlights a critical gap in managing high-risk patients undergoing reconstructive surgery.

This case report details a patient with a history of pyoderma gangrenosum (PG) that developed after multiple breast augmentation procedures. The patient required subsequent breast reconstruction, posing a high risk for PG recurrence. To prevent this, a perioperative prophylactic regimen was implemented for her third breast surgery. The patient received a combination of cyclosporine and prednisone, administered both before and after the procedure. The specific doses and duration of the regimen were tailored to the patient's clinical history and the planned surgical intervention, aiming to mitigate the inflammatory response known to trigger PG.

The perioperative administration of cyclosporine and prednisone successfully prevented the recurrence of pyoderma gangrenosum in the patient undergoing subsequent breast reconstruction.