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Pyoderma gangrenosum during pregnancy – treatment options revisited
Author(s) -
Vigl K.,
Posch C.,
Richter L.,
Monshi B.,
Rappersberger K.
Publication year - 2016
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.13792
Subject(s) - medicine , pyoderma gangrenosum , pregnancy , etiology , dermatology , pathergy , disease , intensive care medicine , thalidomide , differential diagnosis , surgery , obstetrics , pathology , immunology , genetics , biology , multiple myeloma
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. In conjunction with a comprehensive review of previously published cases of PG during gravidity, we discuss available treatment modalities including immunosuppressants and TNF α inhibitors. Results Our patient highlights the importance of including PG as a potential differential diagnosis of cutaneous ulcers during gravidity. Treatment with systemic glucocorticoids is effective and safe for the health of the mother and the unborn. Conclusion In pregnant females, it is particularly important to diagnose PG and control disease activity due to the risk of pathergy and wound healing deficiencies during delivery and post‐partum. A limited number of treatment options are available to date, which require a precise risk–benefit evaluation.