Pyoderma gangrenosum secondary to caesarean section treated with negative pressure wound therapy and skin graft

Abstract

Pyoderma gangrenosum (PG) is a rare dermatosis. The incidence of PG is estimated to be about 3-10 cases per million per year. 1 Its occurrence after surgery or caesarean is even rarer and only a few cases are reported. 2-4 PG lacks specific markers, thus diagnosis is

Postsurgical Pyoderma Gangrenosum Requiring Plastic Surgical Intervention: A Practical Review

“…All were treated with skin grafts. 39,72,78,83 ( Supplemental Digital Content 5 , http://links.lww.com/PRSGO/C963.) One patient also required a jejunostomy and a local flap.…”

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

“…Premature birth occurred in 13 cases due to various emergencies, such as chorioamnionitis, abruptio placenta, and vaginal bleeding [10,20,21,33,35,37,40,[42][43][44]47,48,51]. However, the method of delivery was unspecified in 16 cases [4][5][6]18,24,[27][28][29]31,36,38,39,45,46,49,52], with the remaining cases delivering at term. Notably, 15 cases of postpartum C-section site PG were recurrent [15,24,25,27,30,[32][33][34][40][41][42][43]46,48,52], only 1 case exhibited the first episode of the disease linked to surgical intervention with subsequent relapses [23], and in the rest of the included cases, this was the first manifestation of the disease.…”

“…Karim et al presented a case with a familial history of pyoderma gangrenosum, with the patient's sister also suffering from the disease [26]. Associated pathologies identified included ulcerative colitis [23], chronic type C hepatitis [24,38], Takayasu arteritis and type B hepatitis [27], weakly positive antiphospholipid antigen [14], antiphospholipid syndrome with weakly positive lupus anticoagulant and three spontaneous abortions [37], type B hepatitis [49], thrombocytopenia early in pregnancy [51], and a fatal association between PG and postpartum cardiomyopathy [41].…”

“…Other treatment approaches included systemic corticotherapy and local tacrolimus [10]; systemic corticotherapy and dapsone [33,39]; a combination of corticotherapy, cyclosporine, and dapsone in two cases [29,34]; and a combination of corticotherapy, cyclosporine, and dapsone in Alani et al's case with mycophenolate mofetil [38]. Several cases required complex therapies, such as corticotherapy and azathioprine followed by vacuum-assisted closure and splitthickness skin graft [15]; negative pressure wound therapy and high-dose corticosteroid therapy [43,46]; corticotherapy and human immunoglobulin therapy; wound debride-ment, vacuum sealing negative pressure drainage, skin grafting, and hyperbaric oxygen therapy [4]; intravenous immunoglobulin alone [45]; and corticotherapy combined with intravenous immunoglobulin [49] or cyclosporine with skin grafting [53].…”