Pyoderma gangrenosum or necrotising fasciitis? Diagnostic and therapeutic wanderings.

A case of post-traumatic lower-limb pyoderma gangrenosum (PG) in a 77-year-old female is reported. The diagnosis of PG is frequently one of exclusion, and it is therefore unsurprising that the condition was initially mistaken for necrotising fasciitis then for necrotising bacterial dermo-hypodermitis. Medical and surgical treatment for those conditions proved ineffective. This fact, together with the atypical presentation, promoted a re-evaluation of the diagnosis. The clinical findings and investigation results converged to suggest PG, and a therapeutic trial was initiated. The good treatment response and negative findings from tests for other conditions established the diagnosis of post-traumatic PG.

[Nodular fasciitis: case report and review of the literature]. / La fasciite nodulaire : à propos d'un cas et revue de la littérature.

Among soft tissue tumors, nodular fasciitis is a relatively common tumor process, which occurs in the 30 first years of life. Nodular fasciitis is a benign tumor with a rapid proliferation of myofibroblastic cells, which develops at the expense of a muscular fascia in the subcutaneous tissue. Usual localizations are the trunk and upper limbs. Difficulty of diagnosis consists in the need to eliminate many differential diagnoses especially malignant tumor processes. From a clinical point of view, the rapid development of nodular fasciitis (from some days to some weeks) must fear a malignant process. This benign lesion, which does not recur (even if incomplete resection), may regress spontaneously. We report such a tumor located at the cubital fossa confirmed by a pathological examination.