[Pregnancy: a possible etiology of pyoderma gangrenosum. A case report and review of the literature].
OBJECTIVE
We report an unusual case of pyoderma gangrenosum at 26 weeks gestation and review other cases reported in the literature in order to examine the underlying causes and determine the appropriate diagnostic and therapeutic approach to this uncommon skin disease. Patient and methods. The patient developed an acute abdominal syndrome at 26 weeks gestation (laparotomy was non contributive) followed by pyoderma gangrenosum of the abdominal wall. Seven other cases have been reported in the literature associating pyoderma gangrenosum with pregnancy. We analyzed the clinical findings in these cases.


RESULTS
Corticosteroid therapy successfully controlled pyoderma gangrenosum in our patient. Pregnancy outcome was favorable with little effect on the newborn. Complete healing was achieved after several months of treatment.


CONCLUSIONS
Histological lesions are nonspecific. Diagnosis of pyoderma gangrenosum is generally based on clinical signs. Systemic disease is associated in half the cases (inflammatory bowel disease, myelodysplastic syndrome, rheumatoid arthritis). The impact on pregnancy appears to be limited. Treatment is based on high-dose systemic corticosteroid therapy or cyclosporin. The two drugs may have to be combined. Search for an associated disease and appropriate treatment is particularly important for the outcome of pregnancy.
Sergent
F
F
Clinique Gynécologique et Obstétricale, Pavillon Mère-Enfant, Cedex, France. Fabrice.Sergent@chu-rouen.fr
Joly
P
P
Gravier
A
A
Verspyck
E
E
Marpeau
L
L
D034861:Abdominal Wall; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D015984:Causality; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011256:Pregnancy Outcome / Q000453:epidemiology; D017511:Pyoderma Gangrenosum / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012307:Risk Factors; D013256:Steroids; D016896:Treatment Outcome; D014945:Wound Healing
D000893:Anti-Inflammatory Agents; D013256:Steroids