1887
Volume 2015, Issue 1
  • ISSN: 0253-8253
  • E-ISSN: 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.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2015.1
2015-04-15
2019-10-20
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2015/1/qmj.2015.1.html?itemId=/content/journals/10.5339/qmj.2015.1&mimeType=html&fmt=ahah

References

  1. [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: : 655– 680 .
    [Google Scholar]
  2. [2]. Powell   FC., , Su   WP., , Perry   HO. . Pyoderma gangrenosum: classification and management. . J Am Acad Dermatol.   1996; ; : 410– 412 .
    [Google Scholar]
  3. [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: : 281– 293 .
    [Google Scholar]
  4. [4]. Callen   JP. . Pyoderma gangrenosum. . Lancet . 1998; ;351: 9102 : 581– 585 .
    [Google Scholar]
  5. [5]. Noblett   SE., , Woodcock   S. . Port-Site Pyoderma Gangrenosum– A Rare Complication of Surgical Trauma. . Ann R Coll Surg Engl.   2009; ;91: : 665– 666 .
    [Google Scholar]
  6. [6]. Van den Driesch   P. . Pyoderma gangrenosum: a report of 44 cases with follow- up. . Br J Dermatol . 1997; ;137: : 1000– 1005 .
    [Google Scholar]
  7. [7]. Bolognia   JL., Jorizzo   JL., Rapini   RP. , eds. Pyoderma gangrenosum. Dermatology . London, UK: : Mosby;   2003; ; : 415– 418 .
    [Google Scholar]
  8. [8]. Su   WP., , Davis   MD., , Weenig   RH., , Powell   FC., , Perry   HO. . Pyoderma gangrenosum: clinicopathologic correlation and proposed diagnostic criteria. . Int J Dermatol . 2004; ;43: : 790– 800 .
    [Google Scholar]
  9. [9]. Harland   CC., , Jaffe   W., , Holden   CA., , Ross   LD. . Pyoderma gangrenosum complicating caesarean section. . J Obstet Gynaecol.   1993; ;13: : 115– 116 .
    [Google Scholar]
  10. [10]. Aytekin   S., , Tarlan   N., , Kalkanli   N., , Yaldiz   M., , Unlu   G. . Pyoderma gangrenosum in pregnancy. . J Eur Acad Dermatol Venereol.   2002; ;16: : 546– 548 .
    [Google Scholar]
  11. [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: : 827– 828 .
    [Google Scholar]
  12. [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: : 1116– 1122 .
    [Google Scholar]
  13. [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: : 207– 213 .
    [Google Scholar]
  14. [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: : 931– 934 .
    [Google Scholar]
  15. [15]. Harland   CC., , Jaffe   W., , Holden   CA., , Ross   LD. . Pyoderma gangrenosum complicating caesarian section. . J Obstet Gynaecol.   1993; ;13: : 115– 116 .
    [Google Scholar]
  16. [16]. Stone   N., , Harland   C., , Ross   L., , Holden   C. . Pyoderma gangrenosum complicating caesarian section. . Clin Exp Dermatol.   1996; ;21: : 468 .
    [Google Scholar]
  17. [17]. Steadman   UA., , Brennan   TE., , Daman   LA., , Curry   SL. . Pyoderma gangrenosum following cesarean delivery. . Obstet Gynecol.   1998; ;91: : 834– 836 .
    [Google Scholar]
  18. [18]. Rönnau   AC., , Schmiedeberg   SV., , Bielfeld   P., , Ruzicka   T., , Schuppe   HC. . Pyoderma gangrenosum after caesarean delivery. . Am J Obstet Gynecol.   2000; ;183: : 502– 504 .
    [Google Scholar]
  19. [19]. Banga   F., , Schuitemaker   N., , Meijer   P. . Pyoderma gangrenosum after caesarean section: a case report. . Reprod Health.   2006; ;22: : 1– 5 .
    [Google Scholar]
  20. [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: : 120– 126 .
    [Google Scholar]
  21. [21]. Pauser   S., , Goerge   T., , Eickelmann   M., , Gaubitz   M., , Luger   TA., , Steinhoff   M. . Pyoderma Gangrenosum After Cesarean Delivery. . Clinical Medicine Insights: Dermatology . 2009; ;2: : 23– 26 .
    [Google Scholar]
  22. [22]. Schwaegerle   SM., , Bergfeld   WF., , Senitzer   D., , Tidrick   RT. . Pyoderma gangrenosum: a review. . J Am Acad Dermatol.   1988; ;18: : 559– 568 .
    [Google Scholar]
  23. [23]. Matis   WL., , Ellis   CN., , Griffiths   CE., , Lazarus   GS. . Treatment of pyoderma gangrenosum with cyclosporine. . Arch Dermatol.   1992; ;128: : 1060– 1064 .
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/qmj.2015.1
Loading
/content/journals/10.5339/qmj.2015.1
Loading

Data & Media loading...

  • Article Type: Case Report
Keyword(s): caesarean section , non-healing ulcer , pathergy and pyoderma gangrenosum
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error