1887
Volume 2015, Issue 1
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

A 22-year-old booked primigravida underwent lower segment caesarean section for breech presentation. She developed signs and symptoms of wound infection by the fourth postoperative day. This was initially managed with antibiotics and wound dressing, but debridement was later undertaken after consulting surgeons. This resulted in an alarming worsening of the wound with sudden and fast increase in its size along with systemic symptoms. Wound biopsy established the diagnosis of pyoderma gangrenosum. The patient's management included oral medication with prednisolone, cyclosporin and dapsone and wound care. There was a dramatic response to this treatment. The wound completely healed by the eighth postoperative month. The oral medications were tapered off slowly and stopped by that time.

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2015-04-15
2020-08-06
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References

  1. Brunsting LA, Goeckerman WH, O'Leary PA. Pyoderma (echthyma) gangrenosum:clinical and experimental observations in five cases occurring in adults. Arch Dermatol Syphilol. 1930; 22::655680.
    [Google Scholar]
  2. Powell FC, Su WP, Perry HO. Pyoderma gangrenosum: classification and management. J Am Acad Dermatol. 1996;:410412.
    [Google Scholar]
  3. Farhi D, Cosnes J, Zizi N, Chosidow O, Seksik P, Beaugerie L, Aractingi S, Khosrotehrani K. Significance of erythema nodosum and pyoderma gangrenosum in inflammatory bowel diseases: a cohort study of 2402 patients. Medicine (Baltimore). 2008; 87::281293.
    [Google Scholar]
  4. Callen JP. Pyoderma gangrenosum. Lancet. 1998; 351:9102:581585.
    [Google Scholar]
  5. Noblett SE, Woodcock S. Port-Site Pyoderma Gangrenosum– A Rare Complication of Surgical Trauma. Ann R Coll Surg Engl. 2009; 91::665666.
    [Google Scholar]
  6. Van den Driesch P. Pyoderma gangrenosum: a report of 44 cases with follow- up. Br J Dermatol. 1997; 137::10001005.
    [Google Scholar]
  7. Bolognia JLJorizzo JLRapini RP, eds. Pyoderma gangrenosum. Dermatology. London, UK: Mosby 2003;:415418.
    [Google Scholar]
  8. Su WP, Davis MD, Weenig RH, Powell FC, Perry HO. Pyoderma gangrenosum: clinicopathologic correlation and proposed diagnostic criteria. Int J Dermatol. 2004; 43::790800.
    [Google Scholar]
  9. Harland CC, Jaffe W, Holden CA, Ross LD. Pyoderma gangrenosum complicating caesarean section. J Obstet Gynaecol. 1993; 13::115116.
    [Google Scholar]
  10. Aytekin S, Tarlan N, Kalkanli N, Yaldiz M, Unlu G. Pyoderma gangrenosum in pregnancy. J Eur Acad Dermatol Venereol. 2002; 16::546548.
    [Google Scholar]
  11. Sassolas B, Le Ru Y, Platin P, Lair G, Dupre PF, Cochard G, Guillet G. Pyoderma gangrenosum with pathergic phenomenon in pregnancy. Br J Dermatol. 2000; 142::827828.
    [Google Scholar]
  12. Bernstein CN, Blanchard JF, Rawsthorne P, Yu N. The prevalence of extraintestinal diseases in inflammatory bowel disease: a population-based study. Am J Gastroenterol. 2001; 96::11161122.
    [Google Scholar]
  13. Poucke SV, Jorens PG, Peeters R, Jacobs W, de Beeck BO, Lambert J, Beaucourt L. Pyoderma gangrenosum: a challenging complication of bilateral mastopexy. Int Wound J. 2004; 1::207213.
    [Google Scholar]
  14. Shands JW Jr, Flowers FP, Hill HM, Smith JO. Pyoderma gangrenosum in a kindred. Precipitation by surgery or mild physical trauma. J Am Acad Dermatol. 1987; 16::931934.
    [Google Scholar]
  15. Harland CC, Jaffe W, Holden CA, Ross LD. Pyoderma gangrenosum complicating caesarian section. J Obstet Gynaecol. 1993; 13::115116.
    [Google Scholar]
  16. Stone N, Harland C, Ross L, Holden C. Pyoderma gangrenosum complicating caesarian section. Clin Exp Dermatol. 1996; 21::468.
    [Google Scholar]
  17. Steadman UA, Brennan TE, Daman LA, Curry SL. Pyoderma gangrenosum following cesarean delivery. Obstet Gynecol. 1998; 91::834836.
    [Google Scholar]
  18. Rönnau AC, Schmiedeberg SV, Bielfeld P, Ruzicka T, Schuppe HC. Pyoderma gangrenosum after caesarean delivery. Am J Obstet Gynecol. 2000; 183::502504.
    [Google Scholar]
  19. Banga F, Schuitemaker N, Meijer P. Pyoderma gangrenosum after caesarean section: a case report. Reprod Health. 2006; 22::15.
    [Google Scholar]
  20. Suárez-Pérez JA, Herrera-Acosta E, López-Navarro N, Vilchez-Márquez F, Prieto JD, Bosch RJ, Herrera E. Pioderma gangrenoso: Presentación de 15 casos y revisión de la literatura. Actas Dermosifiliogr. 2012; 103::120126.
    [Google Scholar]
  21. Pauser S, Goerge T, Eickelmann M, Gaubitz M, Luger TA, Steinhoff M. Pyoderma Gangrenosum After Cesarean Delivery. Clinical Medicine Insights: Dermatology. 2009; 2::2326.
    [Google Scholar]
  22. Schwaegerle SM, Bergfeld WF, Senitzer D, Tidrick RT. Pyoderma gangrenosum: a review. J Am Acad Dermatol. 1988; 18::559568.
    [Google Scholar]
  23. Matis WL, Ellis CN, Griffiths CE, Lazarus GS. Treatment of pyoderma gangrenosum with cyclosporine. Arch Dermatol. 1992; 128::10601064.
    [Google Scholar]
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  • Article Type: Case Report
Keyword(s): caesarean section , non-healing ulcer , pathergy and pyoderma gangrenosum
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