Pyoderma Gangrenosum Following Deep Inferior Epigastric Perforator (DIEP) Breast Reconstruction: A Case Report
Bibliographic record
Abstract
Pyoderma gangrenosum (PG) is a rare dermatologic condition manifesting as sterile, rapidly progressing painful skin ulcerations. It is commonly associated with autoimmune disorders such as inflammatory bowel disease. This case report illustrates a severe case of post-surgical pyoderma gangrenosum (PSPG) following bilateral deep inferior epigastric perforator flap breast reconstruction in a 56-year-old Caucasian woman. Factors delaying diagnosis included negative personal/family history of inflammatory disorders and a clinical presentation more suggestive of breast cellulitis. Refractory antibiotic therapy, subsequent ulceration at multiple breast and abdominal incisions, and pathergic response to tissue biopsy supported an eventual clinical diagnosis of PSPG, 12 days postoperatively, despite equivocal histopathologic findings. Initiation of intravenous immunoglobulin, prednisone therapy, local wound care, and avoidance of debridement led to a full resolution by 5 months postoperatively. This study raises awareness for PSPG and highlights the importance of early recognition and urgent dermatology consultation to expedite optimal treatment and minimize subsequent fat necrosis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".