Pyoderma gangrenosum in pregnancy

Pathophysiology of pyoderma gangrenosum (PG): An updated review

“…[40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56] A portion of these cases may be explained by pathergy as they occurred at the site of cesarean section [40][41][42][43][44][45][46][47][48][49] or on the extremities, 40,[50][51][52][53][54][55][56] which are more prone to trauma. Two patients possessed a background of systemic inflammatory disease (relapsing polychondritis 50 and antiphospholipid syndrome 51 ), likely contributing to a predilection for PG formation.…”

Pyoderma gangrenosum and pregnancy: an example of abnormal inflammation and challenging treatment

“…Necrosis was also noted in six of the biopsies, while two biopsies showed signs of vasculitis . Five additional reports did not describe histological findings but noted no microbial growth …”

“…Another report detailed a 25‐year‐old woman with systemic lupus erythematous (SLE) who presented with PG on her right foot . Two other patients were noted to have pre‐eclampsia and two others abruptio placentae (one not previously reported), who developed PG at the site of caesarean section following delivery.…”

“…Pathergy may have been involved in the development of PG in several of the reviewed clinical cases. Eleven reports described women aged 24–43 years who developed PG at the site of caesarean incision 1 day to 4 weeks after delivery …”

“…Several patients were treated with systemic corticosteroids alone, while others were treated with topical or intralesional steroids or both systemic and topical steroids . Around half of the reviewed cases involved treatment with a combination of corticosteroids and other immunomodulating agents, including ciclosporin, dapsone, cyclophosphamide, intravenous immunoglobulin and azathioprine, sometimes to reduce the amount of steroids used in pregnancy or because the patient did not respond to corticosteroids alone …”