Post-traumatic occipital psoriatic plaque complicated by extensive necrotizing fasciitis of the head and neck: a case report and literature review

J Int Med Res. 2018 Aug;46(8):3480-3486. doi: 10.1177/0300060518788490. Epub 2018 Jul 29.

Abstract

Necrotizing fasciitis (NF) is a severe infection involving the superficial fascial layers, subcutaneous cellular tissue, and possibly skin. It usually has a fulminant evolution, rapidly leading to death in the absence of early diagnosis and aggressive surgical treatment. We herein report a rare case of NF secondary to a traumatized occipital psoriatic plaque in an alcoholic 47-year-old woman and compare this case with the published literature. The NF extended to the entire scalp, right face, and posterior and lateral cervical region. Despite the initially guarded prognosis, the patient's survival emphasizes the importance of aggressive surgical treatment with wide excision of all necrotic structures without any aesthetic compromise.

Keywords: Necrotizing fasciitis; infection; oral and maxillofacial surgery; psoriasis vulgaris; psoriatic plaque; trauma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Alcoholism / complications
  • Anti-Bacterial Agents / therapeutic use*
  • Craniocerebral Trauma / complications*
  • Debridement
  • Face
  • Fasciitis, Necrotizing / drug therapy
  • Fasciitis, Necrotizing / etiology
  • Fasciitis, Necrotizing / surgery*
  • Female
  • Humans
  • Middle Aged
  • Neck
  • Prognosis
  • Psoriasis / complications*
  • Reoperation
  • Scalp
  • Superficial Back Muscles / transplantation
  • Surgical Flaps

Substances

  • Anti-Bacterial Agents