Necrotizing fasciitis as a complication of depilatory cream

Abstract

Necrotizing fasciitis (NF) is an infectious disease, which is characterized by rapidly progressive necrosis of the skin, subcutaneous tissue, and fascia. The skin is involved in the late stage of the disease. It is a very rare but a life-threatening condition if it is not diagnosed early and treated promptly. Comorbidities and concomitant medications should be carefully considered when managing patients with NF. We present the case of a 92-year-old patient with diabetes mellitus diagnosed with NF that spreads to lower abdomen, bilateral inguinal region, and pubic area after applying a depilatory cream to the mons pubis and the area just below the pubic bone. Rapidly and aggressive surgical debridement of the necrotic tissue was applied and negative pressure wound therapy was immediately applied with a vacuum-assisted closure device (VAC). Broad-spectrum antibiotics were used to treat infection. After several VAC therapy applications during the treatment period, the final stage of the treatment was the reconstruction of the resulting defect with split-thickness skin graft. Early and aggressive debridement, broad-spectrum antibiotherapies constitute the mainstay of treatment. Concurrently, serial debridement and rapidly intervention also shorten healing time and hospital stay.