Pyoderma gangrenosum following an unplanned caesarean section: a patient revisited

BMJ Case Rep. 2021 Feb 22;14(2):e238702. doi: 10.1136/bcr-2020-238702.

Abstract

A 35-year-old woman was referred urgently to the dermatology department because of significant wound breakdown 3 weeks following an emergency caesarean section. Examination revealed a full thickness, undermined ulcer spanning the width of the patient's caesarean scar, exposing the patient's uterus. Clinical appearances were consistent with pyoderma gangrenosum. The patient has a history of complicated pyoderma gangrenosum, having undergone skin grafts 14 years prior, for ulcers on her lower legs. That episode was the subject of a case report, published in the BMJ, in 2007. On this occasion, the patient was treated with oral corticosteroids, and ciclosporin based on its efficacy during her previous episode, which in conjunction with negative pressure wound therapy, resulted in complete re-epithelialisation of her ulcer within 6 months.

Keywords: dermatology; obstetrics and gynaecology; wound care.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones
  • Adult
  • Cesarean Section / adverse effects
  • Female
  • Humans
  • Negative-Pressure Wound Therapy*
  • Pregnancy
  • Pyoderma Gangrenosum* / drug therapy
  • Pyoderma Gangrenosum* / etiology
  • Skin Transplantation

Substances

  • Adrenal Cortex Hormones