PMC9494791_01
Non-healing wound after plate removal.
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One month after the implant removal, the surgical wound presented as ulceration with fistulae and purulent discharge (Fig. 1); radiographs revealed osteolysis within the styloid process of the radius.
External fixation for pathologic fracture in the site of the bone defect. PG was diagnosed at that moment.
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As new purulent skin lesions appeared, we took skin and bone biopsies (Fig. 2).
A, B. Severe deformation and osteomyelitis of the forearm and wrist.
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A, B. Massive relapse of PG at the site of scars from healed previous lesions. Note edema of the hand because of clenched and damaged veins.
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Given the poor patient tolerance of the treatment and two episodes of superinfection, the immunologic treatment was not continuous, leading to a massive PG relapse (Fig. 4 A, B).