Pyoderma gangrenosum in pregnancy

Pathophysiology of pyoderma gangrenosum (PG): An updated review

“…[40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56] A portion of these cases may be explained by pathergy as they occurred at the site of cesarean section [40][41][42][43][44][45][46][47][48][49] or on the extremities, 40,[50][51][52][53][54][55][56] which are more prone to trauma. Two patients possessed a background of systemic inflammatory disease (relapsing polychondritis 50 and antiphospholipid syndrome 51 ), likely contributing to a predilection for PG formation.…”

Pyoderma gangrenosum and pregnancy: an example of abnormal inflammation and challenging treatment

“…Eighteen reports (including the present one) include histological findings; all described neutrophilic infiltrate . Necrosis was also noted in six of the biopsies, while two biopsies showed signs of vasculitis .…”

“…Band neutrophils contain more myeloperoxidase, which causes them to be more active and bactericidal, possibly predisposing a pregnant woman to the overactive, neutrophil‐dominant lesions found in PG . Of the cases reviewed, only four patients developed PG in the first trimester . One had a systemic inflammatory illness, relapsing polychondritis, which alone increases the patient's risk of developing a separate inflammatory condition such as PG, and may help explain its occurrence much sooner than the other cases reviewed …”

“…Thirteen reports also documented PG lesions occurring in locations that are often associated with trauma and bruising, such as the arms, legs and feet . Notably, two of these patients also developed PG lesions at the site of caesarean sections as described above …”

“…30,33,[39][40][41][42][44][45][46][47][48] Thirteen reports also documented PG lesions occurring in locations that are often associated with trauma and bruising, such as the arms, legs and feet. 28,29,31,[34][35][36][43][44][45][49][50][51][52] Notably, two of these patients also developed PG lesions at the site of caesarean sections as described above. 45,47 Gestational age at development of pyoderma gangrenosum Gestational age appears to play a role in the development of PG.…”