title: Pyoderma gangrenosum induced by episiotomy.
abstract: We present a patient who developed genital ulceration within hours following episiotomy procedure during a normal vaginal delivery. This was initially treated by the gynaecology and medical team as cellulitis with no improvement. A diagnosis of pyoderma gangrenosum (PG) was made by the dermatology team 12 days later. On further investigation, she was found to be hepatitis C positive. We report this case to highlight the phenomenon of pathergy and frequent misdiagnosis of PG by other medical teams. When a postsurgical wound is not healing despite relevant systemic treatment, the clinician should suspect PG as an early diagnosis and treatment is crucial.
authors.affiliation: Dermatology Department, Limerick University Hospital, Limerick, Ireland.
authors.forename: Angela
authors.initials: A
authors.lastname: Alani
authors.affiliation: Dermatology Department, Limerick University Hospital, Limerick, Ireland.
authors.forename: Muriel
authors.initials: M
authors.lastname: Sadlier
authors.affiliation: Dermatology Department, Limerick University Hospital, Limerick, Ireland.
authors.forename: Bart
authors.initials: B
authors.lastname: Ramsay
authors.affiliation: Dermatology Department, Limerick University Hospital, Limerick, Ireland.
authors.forename: Kashif
authors.initials: K
authors.lastname: Ahmad
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage; D000897:Anti-Ulcer Agents / Q000008:administration & dosage; D002990:Clobetasol / Q000008:administration & dosage; D003622:Dapsone / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004841:Episiotomy / Q000009:adverse effects*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D009853:Omeprazole / Q000008:administration & dosage / Q000627:therapeutic use; D011239:Prednisolone / Q000008:administration & dosage; D017511:Pyoderma Gangrenosum / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology*; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D000890:Anti-Infective Agents; D000897:Anti-Ulcer Agents; D005938:Glucocorticoids; D003622:Dapsone; D011239:Prednisolone; D002990:Clobetasol; D009853:Omeprazole