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pyoderma gangrenosum and pregnancy

Angela S Gupta, Julia R Nunley, Michael J Feldman, Alex G Ortega-Loayza
Pyoderma gangrenosum (PG) is a rare, neutrophil-predominant dermatosis that usually presents as a papule or pustule and progresses into a painful ulcer. Clinical and histopathological features are nonspecific, making PG a challenging condition to diagnose. Lesions may occur anywhere on the body; however, the lower extremity is the most common location. Solitary lesions in atypical locations such as the scalp are uncommon, making this clinical variant especially difficult to recognize and diagnose. Although the clinical features and subsequent management of scalp PG might be different from other anatomic sites, the typical presentation and treatment of scalp PG is still unclear...
February 2018: Wounds: a Compendium of Clinical Research and Practice
I Naciri, M Meziane, L Benzekri, M Ghaouti, K Senouci, B Hassam
BACKGROUND: We report a case of recurrent post-partum pyoderma gangrenosum (PG) complicated by post-partum cardiomyopathy (PPCM). PATIENTS AND METHODS: A 23-year-old woman presented with a previous medical history of aseptic abscess of the left breast in her fourth pregnancy, which developed after surgical drainage of an inflammatory ulceration treated by atraumatic topical care. During her fifth pregnancy, the patient presented a large and painful ulceration in relation to the scar of the Caesarean section, despite the introduction of broad-spectrum antibiotic therapy...
December 6, 2017: Annales de Dermatologie et de Vénéréologie
Julia D Stiegler, Catherine T Lucas, Naveed Sami
No abstract text is available yet for this article.
September 2017: JAAD Case Reports
Naoki Takeshita, Akiko Takashima, Hiroaki Ishida, Megumi Manrai, Toshihiko Kinoshita
Pyoderma gangrenosum (PG) is a rare ulcerative skin disease that usually starts as a pustular lesion and rapidly progresses to a painful ulcer with undermined violaceous borders. The occurrence of PG during pregnancy is uncommon. We describe a case of a pregnant patient with PG who was diagnosed as having ulcerative colitis after delivery. Obstetricians need to understand the pathogenesis of PG and its associated conditions because it is important to make a proper diagnosis and provide targeted therapy.
April 2017: Journal of Obstetrics and Gynaecology Research
Isao Horiuchi, Yuko Fukatsu, Junko Ushijima, Eishin Nakamura, Koki Samajima, Kanako Kadowaki, Kenjiro Takagi
Little is known about the influence of pregnancy on pyogenic sterile arthritis, pyoderma gangrenosum, acne (PAPA) syndrome. We experienced a rare case of pregnancy complicated with PAPA syndrome. The patient had various histories of skin and joint disorders and experienced subarachnoid hemorrhage during pregnancy; however, her skin lesion was unaffected.
October 2016: Clinical Case Reports
K Vigl, C Posch, L Richter, B Monshi, K Rappersberger
BACKGROUND: Pyoderma gangrenosum (PG) is a rare, ulcerating neutrophilic dermatosis of unknown aetiology; PG during pregnancy is particularly rare. The disease is frequently associated with immune-mediated, inflammatory diseases. OBJECTIVE: Diagnosis of PG can be challenging and relies upon exclusion of other causes such as traumas, infections, vascular diseases or neoplasms. Treatment options during pregnancy are limited. METHODS: To evaluate current treatment options for PG during pregnancy, we present a case of multilocular PG during the patient's first trimester...
November 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Jee Yoon Park, JoonHo Lee, Joong Shin Park, Jong Kwan Jun
Pyoderma gangrenosum is an extremely rare chronic cutaneous disease causing severe ulceration. It can be developed after minor trauma or surgical procedure. The typical features mimic acute infection site, however the treatment methods are opposing since pyoderma gangrenosum is improved with the use of corticosteroids, not antibiotic therapy. We here report a patient who had been diagnosed for acute infection after cesarean delivery in 2011 and treated with a number of antibiotics, but failed to recover. The patient had suffered from pain of the disease and also renal failure caused by antibiotics...
January 2016: Obstetrics & Gynecology Science
R B Steele, W H Nugent, S F Braswell, S Frisch, J Ferrell, A G Ortega-Loayza
Pyoderma gangrenosum (PG) is a neutrophil-predominant inflammatory disease that initially presents as a sterile pustule and may progress to ulcerations. Its root cause is unknown, but the presentation is commonly associated with systemic inflammatory conditions such as inflammatory bowel disease, arthritis and haematological abnormalities. On the other hand, pregnant women show a progressive neutrophilia during gestation, which culminates in a major inflammatory event to help drive labour. Although uncommonly, PG has been associated with pregnancy, which provides an additional link to systemic inflammation as an underlying cause of PG...
January 2016: British Journal of Dermatology
Y Renert-Yuval, Y Ramot, I Ophir, A Ingber, L Horev
No abstract text is available yet for this article.
January 2016: Clinical and Experimental Dermatology
E Cozzani, G Gasparini, A Parodi
Pyoderma gangrenosum (PG) is a rare, chronic neutrophilic dermatosis of unknown etiology. The world wide incidence is estimated to be around 3-10 cases per million population per year. In 50-70% of cases inflammatory bowel diseases, hematological malignancies or rheumatologic disorders are associated to PG. Although the etiology is uncertain, the dysregulation of the immune system appears to be implied. Pathergy is the most important triggering factor of PG. Indeed, 20-30% of patients report the onset of PG following trivial trauma...
October 2014: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
Seika Ohno, Jun Ariyama, Miki Tsujita, Hironobu Ueshima, Hirokazu Imanishi, Kazuhisa Terao, Tsutomu Mieda, Akira Kitamura
A 31-year-old female, with 22 weeks of pregnancy, presented with sudden onset of severe headache. CT scan showed diffuse subarachnoid hemorrhage. A cerebral angiogram showed dissecting aneurysm of right cerebral artery. To obliterate the aneurysm and prevent rupture, the patient underwent coil embolization via an endovascular approach under general anesthesia because the procedure under sedation with local anesthesia was too risky for re-bleeding. The patient has been diagnosed as PAPA syndrome. Although the arthritis was now stable and she was taking no drug, remarkable osteoarthritis was observed...
August 2014: Masui. the Japanese Journal of Anesthesiology
Sapna Vinit Amin, Neha Bajapai, Ashwini Pai, Sunanda Bharatnur, Shripad Hebbar
Pyoderma gangrenosum (PG) is a rare ulcerative cutaneous disorder with tendency to recur in the injured area. Though most of the time is associated with chronic systemic conditions, it can occur in isolation and can be a diagnostic dilemma. The aetiology is poorly understood. The diagnosis is based on clinical features and excluding other causes of skin ulcers, as it does not have characteristic histopathology or laboratory findings. Lesions can develop after surgery, after trauma or de novo. We are reporting a 32-year-old pregnant lady with two previous instances of pyoderma gangrenosum in the previous pregnancy, who in postoperative period following caesarean section developed the same condition for the third time...
2014: Case Reports in Obstetrics and Gynecology
Daniel De Menezes, Erlangga Yusuf, Olivier Borens
BACKGROUND: Pyoderma gangrenosum is an ulcerative, non-infectious skin disorder. However, it can be mistaken as necrotizing fasciitis, a life-threatening infective condition. We describe here a case of pyoderma gangrenosum after minor trauma treated as necrotizing fasciitis. METHODS: Case report and literature review. CASE REPORT: A 27-year-old pregnant nurse had a pretibial wound after a fall on a rough surface. When erythema developed and no response to empirical antibiotic therapy was observed, multiple debridements were performed...
August 2014: Surgical Infections
Cornelia Erfurt-Berge, Christine Herbst, Gerold Schuler, Juergen Bauerschmitz
BACKGROUND: Pyoderma gangrenosum is a rare ulcerative skin disease usually starting with a pustular lesion that rapidly progresses to painful ulcers with undermined violaceous borders. Numerous associated disorders have been described, including inflammatory bowel disease, rheumatologic or hematologic disorders, chronic active hepatitis, and malignancies. The occurrence of pyoderma gangrenosum during pregnancy is uncommon. OBJECTIVE: We report a case of a patient with an aggravation of preknown pyoderma gangrenosum during pregnancy who was successfully treated with intravenous immunoglobulins...
May 2012: Journal of Cutaneous Medicine and Surgery
Christian Mottet, John-Paul Vader, Christian Felley, Florian Froehlich, Jean-Jacques Gonvers, Pascal Juillerat, Reinhold Stockbrügger, Erika Angelucci, Frank Seibold, Pierre Michetti, Valérie Pittet
INTRODUCTION: High-grade evidence is lacking for most therapeutic decisions in Crohn's disease. Appropriateness criteria were developed for upper gastro-intestinal, extra-intestinal manifestations and drug safety during conception, pregnancy and breastfeeding in patients with Crohn's disease, to assist the physician in clinical decision making. METHODS: The European Panel on the Appropriateness of Crohn's Disease Therapy (EPACT II), a multidisciplinary international European expert panel, rated clinical scenarios based on evidence from the published literature and panelists' own clinical expertise...
December 2009: Journal of Crohn's & Colitis
Uwe Wollina, Gunter Haroske
PURPOSE OF REVIEW: To describe current progress in understanding pyoderma gangraenosum, illustrate clinical observations and discuss therapeutic interventions. RECENT FINDINGS: The proline-rich, glutamic acid-rich, serine-rich and threonine-rich (PEST) family of protein tyrosine phosphatases is a critical regulator of adhesion and migration. PSTPIP1 is a cytoskeleton-associated adaptor protein that links PEST-type phosphatases to their substrates. This pathway seems to be involved in diseases related to pyoderma gangraenosum such as chronic inflammatory bowel disease and aseptic abscesses syndrome...
January 2011: Current Opinion in Rheumatology
E Wierzbicka-Hainaut, H Le Naoures, F Bonneric-Malthieu, P Debiais, P Levillain, F Pierre, G Guillet
BACKGROUND: We report the case of a 25-year-old patient developing pyoderma gangrenosum (PG) during the third trimester of her first and second pregnancies. CASE REPORT: A 25-year-old woman developed PG on her left calf during week 32 of her second pregnancy; previously, during week 36 of her first pregnancy, the patient had presented abdominal pain with inflammatory syndrome. She underwent caesarean delivery at week 37 of pregnancy. Surgery was complicated by aseptic abdominal and parietal abscesses as well as aseptic endometritis with neutrophil infiltrate...
March 2010: Annales de Dermatologie et de Vénéréologie
Irene C Wiersma, Babette A M Braams-Lisman, Jan R Mekkes
No abstract text is available yet for this article.
April 11, 2009: Nederlands Tijdschrift Voor Geneeskunde
C Sanz-Muñoz, C Martínez-Morán, A Miranda-Romero
We describe the case of a 30-year-old woman who, 5 days after giving birth to her first child by cesarean section, presented with dehiscence of one end of the surgical wound and a lesion on her leg that developed into a well-defined ulcer; both lesions were very painful. The patient was initially diagnosed with a skin infection and later with superficial pyoderma gangrenosum. The lesions were treated with topical corticosteroids and a good response was observed. No evidence was found of underlying disease. Isolated cases of pyoderma gangrenosum associated with pregnancy or cesarean delivery have been reported in the literature...
July 2008: Actas Dermo-sifiliográficas
Kavitha Reddy, Lori Brightman, Suraj Venna
Pyoderma gangrenosum (PG) is a rare chronic ulcerative skin condition often associated with systemic disease. PG associated with pregnancy is an extremely rare presentation; only 9 other cases have been reported in the literature. We present PG in a pregnant patient (third trimester) with pathergy. No associated systemic disease was identified. Histology was consistent with PG and the lesions responded to intralesional triamcinolone therapy.
March 2008: Cutis; Cutaneous Medicine for the Practitioner
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