Cutaneous gangrene: Cutaneous gangrene is the most feared, medical condition caused by a physician’s treatment, and it involves the greatest medical-legal liability and is more likely to cause legal disputes, as is acute drug anaphylaxis. Skin gangrene may have two distinct etiologies, one of chemical or pharmacologic origin and the other of biological origin. The chemical etiology of skin gangrene is a vascular crisis caused by the use of drugs with vasoconstrictive properties or excipients that are too thick and irritating. It is now known that a high concentration of some AINES and mucopolysaccharide depolymerases, especially when combined with hematomas, may in turn trigger the symptoms of cutaneous gangrene. In other cases, cutaneous gangrene appears as a result of a mixture of drugs rather than just a single drug. Treatment of skin gangrene should turn to products whose primary effect is healing (crusting). The impact of biologically-derived skin gangrene is much greater. The initial damage appears more slowly, usually after a few weeks. When it first appears, its symptoms are somewhat erythematous and resemble corynebacterial papules. It slowly develops into an ulcer, the surface of which shows a pus-laden ooze. Gangrene of biological origin appears at first only at the site of the lanced needle, but gradually it spreads over long distances, appearing far from the original wound. Biologically histologically, it is a tuberculosis-like granuloma (sarcoidosis) that can occur on any layer of the skin and will have significant infiltration of histiocytes, lymphocytes, plasma cells, and giant cells, around which an area of cheese-like necrosis will appear. This type of skin gangrene is generally only seen in cases where biological factors are more favorable to treatment. Usually the lancing is too deep and a hematoma is also present. For this type of skin gangrene, the main focus should be on prevention. The main preventive measures are the following: 1. Very careful disinfection of the skin must be implemented. 2. Do not use needleless syringes. 3. The depth of the needle must not exceed 4 mm. 4. The dose of the drug used for the needle must be microscopically adjusted. 5. Once the treatment has been administered, care must be taken to avoid contact between the wound and dirty clothing. If skin gangrene of biological origin has formed, treatment is carried out by draining the pus from the wound and administering antibiotics throughout the body with quinoladasfluoradas, a fluoroquinolone antibiotic. Antibiotics can be used in addition to fluoroquinolones, but also ciprofloxacin and ofloxacin. Other: Biliary colic may occur after mesotherapy with artichoke extracts (e.g., Chophytol). There is a risk of inguinal lymphadenitis, a pathological type of Atypical Mycobacterium tuberculosis infection, in candidates undergoing treatment for orange peel. In some diseases (such as psoriasis, aspergillosis or lupus erythematosus, etc.), treatment of either pathogen may cause damage similar to that listed previously at the site of skin destruction (the so-called Köbner K?bner phenomenon), but this is not a constant and ironclad rule. Tip: Necrotizing pyoderma is a chronic, necrotizing, ulcerative, scarring, painful skin disease. It occurs in men aged 30 to 40 years, with the face, shoulders, and back as common sites. The diagnosis depends mainly on the clinical presentation. Inflammatory papules, pustules, and nodules with rapid formation of submerged ulcers and severe pain should be considered for this disease.