31: A rare case of pyoderma gangrenosum and the effects of pathergy in a postpartum patient

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

“…We conducted a literature review to ascertain the prevalence of postpartum PG cases, identifying a total of 41 instances [4][5][6]10,14,15,18,, including two documented in posters [35,53]. Among these cases, there is one that reported two occurrences of PG [42], while the remaining authors presented singular instances (Table 1).…”

“…Roa and Futami et al presented cases of PG in patients who gave birth vaginally, while the means of birth were unspecified in Aoussar et al and Lyons et al [6,23,27,53]. 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.…”

Pyoderma Gangrenosum a Diagnosis not to Miss: Case Report

“…It may happen spontaneously, after surgery (6 to 14 days) or due to injury (1,2) . An aggressive surgery may worsen the lesion; it's the pathergy effect (5) . The microbiological samples are often negative.…”

“…It can be underdiagnosed. Indeed, it can mimic necrotizing fasciitis (a lot of cases were described), surgical wound infection, bacterial necrotizing dermohypodermitis, cutaneous infection, sepsis, sweet syndrome ulcerative form, malignant lesion, vascular disorder (5) . We had the same problem with our patient, firstly we considered the breast lesion as a fasciitis necrosis and then the wound lesion as a superinfection of it.…”

“…In fact, we must in a first time eliminate the other causes of similar skin ulceration (2) , a wound "infection" or infection cellulitis (2) . The diagnosis is based on the clinical grounds: if the lesion decreases after systemic corticoid therapy (5) . The absence of germs in the different test, the noamelioration after anti-microbial treatment (2,4) .…”