Perineal pyoderma gangrenosum in pregnancy: A case report

Abstract

Pyoderma gangrenosum is a rare ulcerating neutrophilic dermatosis. We describe the case of a 28-year-old woman with pyoderma gangrenosum in the perineal region during pregnancy. Cytological analysis of a skin biopsy specimen showed neutrophilic infiltrates across all the layers of the dermis, confirming the diagnosis of pyoderma gangrenosum. Determining a management plan, including the mode of delivery, was difficult. Oral prednisolone was started and her ulcer started to improve, but she still had the ulcer when she reached full term. Because there was a concern that the ulcer would be worsened by vaginal delivery, cesarean section was performed. After her delivery, pyoderma gangrenosum had not appeared at the cesarean incision and the ulcer in the perineal region had improved. Obstetricians should be aware of pyoderma gangrenosum as a differential diagnosis when vulvar ulceration develops during pregnancy.

Pyoderma Gangrenosum, a Challenging Postpartum Diagnosis—Case Report and Literature Review

“…The second most utilized drug in the treatment of PG is systemic cyclosporine, which is known for causing hypertension and nephrotoxicity. Therefore, these commonly used drugs for treating PG require careful consideration during pregnancy [19,[63][64][65][66].…”

Concurrent Scleredema and Pyoderma Gangrenosum: Case Report and Review of Comorbid Conditions

“…Oral prednisolone was started, but the ulcer was still present at the end of her pregnancy. A cesarean section was performed, and the perineal ulcer resolved one month later [ 18 ].…”

“…Both diseases can be associated with monoclonal gammopathy [ 3 , 14 ]. Single patients with other conditions in common include pregnancy and chronic myeloid leukemia [ 9 , 10 , 16 , 18 ]. Diabetes has also been described in pyoderma gangrenosum patients; however, this may be a coincidental finding and not related to neutrophilic dermatosis [ 17 ].…”

“…Many diseases can be associated with pyoderma gangrenosum; these are summarized in Table 2 [12,[14][15][16][17][18][19]. The most common is inflammatory bowel disease, which has been found in two-thirds of patients with pyoderma gangrenosum.…”