a port wound after laparoscopic gastrectomy. If atypical clinical findings of postoperative SSI are observed, general surgeons should recognize and treat PPG as a possible differential diagnosis.AcknowledgementsAll authors acknowledge no forms of financial support, including technical assistance and advice. We would like to thank Enago (www.enago.jp) for the English language review. No funding was received for this report. Author contributionsSY, YA and KS drafted the manuscript. KS, YY and AK performed surgery. CJ, HE and YY contrib-uted to patient care. TF, HO gave final approval of the manuscript. All authors read and approved the final manuscript. Conflicts of interest statementThe authors declare that they have no conflicts of interests. 1) Rozen SM, Nahabedian MY, Manson PN: Management strategies for pyoderma gangrenosum: case studies and review of literature. Ann Plast Surg, 2001; 47: 310- 315. 2) Brooklyn T, Dunnill G, Probert C: Diagnosis and treat-ment of pyoderma gangrenosum. Bmj, 2006; 333: 181- 184. 3) Esnault P, Dompmartin A, Moreau A, Caraes B, Leroy D: Recurring postoperative pyoderma gangrenosum. Int J Dermatol, 1995; 34: 647-650. 4) Niezgoda JA, Cabigas EB, Allen HK, Simanonok JP, Kindwall EP, Krumenauer J: Managing pyoderma gangrenosum: a synergistic approach combining surgical débridement, vacuum-assisted closure, and hyperbaric oxygen therapy. Plast Reconstr Surg, 2006; 117: 24e-28e. 5) Patel F, Fitzmaurice S, Duong C, et al: Effective strat-egies for the management of pyoderma gangrenosum: a comprehensive review. Acta Derm Venereol, 2015; 95: 525-531. 6) Powell FC, Schroeter AL, Su WP, Perry HO: Pyoderma gangrenosum: a review of 86 patients. Q J Med, 1985; 55: 173-186. 7) Ruocco E, Sangiuliano S, Gravina AG, Miranda A, Nico-letti G: Pyoderma gangrenosum: an updated review. J Eur Acad Dermatol Venereol, 2009; 23: 1008-1017. 8) Braswell SF, Kostopoulos TC, Ortega-Loayza AG: Pathophysiology of pyoderma gangrenosum (PG): an updated review. J Am Acad Dermatol, 2015; 73: 691- 698. 9) Ahronowitz I, Harp J, Shinkai K: Etiology and manage-ment of pyoderma gangrenosum: a comprehensive review. Am J Clin Dermatol, 2012; 13: 191-211.10) Binus AM, Qureshi AA, Li VW, Winterfield LS: Pyoderma gangrenosum: a retrospective review of patient characteristics, comorbidities and therapy in 103 patients. Br J Dermatol, 2011; 165: 1244-1250.11) Brooklyn TN, Dunnill MG, Shetty A, et al: Infliximab for the treatment of pyoderma gangrenosum: a randomised, double blind, placebo controlled trial. Gut, 2006; 55: 505-509.12) Hadi A, Lebwohl M: Clinical features of pyoderma gangrenosum and current diagnostic trends. J Am Acad Dermatol, 2011; 64: 950-954.13) von den Driesch P: Pyoderma gangrenosum: a report of 44 cases with follow-up. Br J Dermatol, 1997; 137: 1000-1005.14) Tolkachjov SN, Fahy AS, Wetter DA, et al: Postopera-tive pyoderma gangrenosum (PG): the Mayo Clinic experience of 20 years from 1994 through 2014. J Am Acad Dermatol, 2015; 73: 615-622.15) Tolkachjov SN, Fahy AS, Cerci FB, Wetter DA, Cha SS, Camilleri MJ: Postoperative Pyoderma Gangre-nosum: A Clinical Review of Published Cases. Mayo Clin Proc, 2016; 91: 1267-1279.16) Patel DK, Locke M, Jarrett P: Pyoderma gangrenosum with pathergy: A potentially significant complication following breast reconstruction. J Plast Reconstr Aesthet Surg, 2017; 70: 884-892.17) Wall LB, Stern PJ: Pyoderma gangrenosum. J Hand Surg Am, 2012; 37: 1083-1085.18) Zuo KJ, Fung E, Tredget EE, Lin AN: A systematic review of post-surgical pyoderma gangrenosum: iden-tification of risk factors and proposed management strategy. J Plast Reconstr Aesthet Surg, 2015; 68: 295- 303.19) Yoshida K, Honda M, Kumamaru H, et al: Surgical outcomes of laparoscopic distal gastrectomy compared to open distal gastrectomy: A retrospective cohort study based on a nationwide registry database in Japan. Ann Gastroenterol Surg, 2018; 2: 55-64.20) Callen JP, Jackson JM: Pyoderma gangrenosum: an update. Rheum Dis Clin North Am, 2007; 33: 787-802, vi.21) Reichrath J, Bens G, Bonowitz A, Tilgen W: Treatment recommendations for pyoderma gangrenosum: an evidence-based review of the literature based on more than 350 patients. J Am Acad Dermatol, 2005; 53: 273- 283.22) Partridge ACR, Bai JW, Rosen CF, Walsh SR, Gulliver WP, Fleming P: Effectiveness of systemic treatments for pyoderma gangrenosum: a systematic review of observational studies and clinical trials. Br J Dermatol, 2018; 179: 290-295.23) Thomas KS, Ormerod AD, Craig FE, et al: Clinical outcomes and response of patients applying topical therapy for pyoderma gangrenosum: A prospective cohort study. J Am Acad Dermatol, 2016; 75: 940-949.24) Miller J, Yentzer BA, Clark A, Jorizzo JL, Feldman SR: Pyoderma gangrenosum: a review and update on new therapies. J Am Acad Dermatol, 2010; 62: 646-654.525Funding References
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