title: Pyoderma gangrenosum and pregnancy: an example of abnormal inflammation and challenging treatment.
abstract: 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. We reviewed documented presentations of PG in gravid and post-partum patients, and have speculated on the possible pathogenesis based on their clinical presentations. Also, we summarize the reported treatments and their outcomes in these patients.
authors.affiliation: Department of Dermatology, Virginia Commonwealth University, Richmond, VA, U.S.A.
authors.forename: R B
authors.initials: RB
authors.lastname: Steele
authors.affiliation: Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA, U.S.A.
authors.forename: W H
authors.initials: WH
authors.lastname: Nugent
authors.affiliation: Department of Dermatology, Virginia Commonwealth University, Richmond, VA, U.S.A.
authors.forename: S F
authors.initials: SF
authors.lastname: Braswell
authors.affiliation: Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, U.S.A.
authors.forename: S
authors.initials: S
authors.lastname: Frisch
authors.affiliation: Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, U.S.A.
authors.forename: J
authors.initials: J
authors.lastname: Ferrell
authors.affiliation: Department of Dermatology, Virginia Commonwealth University, Richmond, VA, U.S.A.
authors.forename: A G
authors.initials: AG
authors.lastname: Ortega-Loayza
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D003872:Dermatitis / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D008487:Medical History Taking; D009504:Neutrophils / Q000473:pathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D011295:Prenatal Care / Q000379:methods; D017511:Pyoderma Gangrenosum / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D012008:Recurrence; D013256:Steroids / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D013256:Steroids