Diminished Maternal Tryptophan Leads to Sexually Dimorphic Differences in the Placenta-Brain Axis.

Post-surgical pyoderma gangrenosum (PPG) is an uncommon and often misdiagnosed variant of neutrophilic dermatosis that occurs following surgical trauma, typically in previously healthy individuals. Clinically, it presents as rapidly progressive, painful ulcers at surgical sites, often mistaken for wound infections, which may lead to unnecessary antibiotic use or surgical debridement, ultimately worsening the condition. Although its pathogenesis remains poorly understood, PPG is considered to result from an abnormal immune response in genetically predisposed individuals. The dysregulation of neutrophilic chemotaxis, coupled with aberrant T cell activation, leads to an overproduction of interleukin-17 (IL-17) and subsequent release of proinflammatory cytokines such as IL-1β, IL-8, and tumor necrosis factor-α (TNF-α). These mediators amplify neutrophilic infiltration and tissue destruction.

A phenomenon known as pathergy—the development or worsening of lesions after minor trauma or surgery—is characteristic of pyoderma gangrenosum (PG) and particularly relevant in the postoperative setting.

Some patients have associated systemic diseases, especially inflammatory bowel disease.


The diagnosis is primarily clinical, based on exclusion of infections and other ulcerative dermatoses, and it is supported by compatible histopathological findings in selected cases. Treatment usually involves systemic corticosteroids and/or immunosuppressive agents. Adjunctive therapies such as hyperbaric oxygen therapy (HBOT) may be considered, as it promotes tissue healing by increasing oxygen availability in ischemic or inflamed areas.