Pyoderma gangrenosum following pelvic and femoral osteotomy in an 8-Year-Old Girl with Cri-du-chat syndrome: A case report.

Background: Postoperative pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis frequently misdiagnosed as wound infection, leading to unnecessary surgical debridement and potential worsening of tissue destruction through pathergy. Pediatric PG is rare, accounting for <4% of cases and is often diagnostically underrecognized, with reported delays of approximately two months. Case Presentation: We report the case of an 8-year-old girl with Cri-du-chat syndrome who developed postoperative PG following femoral and pelvic osteotomy. Initial wound deterioration was attributed to infection; however, persistently sterile cultures and compatible histopathological findings as well as clinical presentation led to the diagnosis of PG on postoperative day 28. Following high-dose corticosteroids, a pedicled anterolateral thigh (ALT) flap was successfully used to reconstruct the resulting groin defect on postoperative day 41. Discussion: This case underscores the diagnostic challenges of postoperative PG in the pediatric population following orthopedic surgery. It further suggests that pedicled flap reconstruction may be a feasible option following disease stabilization under continued immunosuppressive therapy. Conclusion: Early recognition of postoperative PG is essential to avoid potentially harmful debridement and enable timely immunosuppressive therapy, allowing safe reconstructive intervention following disease stabilization.