title: Case with pyoderma gangrenosum abruptly emerging around the wound of cesarean section for placenta previa with placenta accrete.
abstract: A 39-year-old woman underwent emergency cesarean section (CS) due to placenta previa totalis with massive bleeding. Two major problems emerged in this patient after CS was carried out. One was partial retention of the placenta due to placenta accreta. Another major and more serious problem was pyoderma gangrenosum (PG) widely appearing at the skin of the abdomen around the CS wound. Conservative treatment was performed for the retained placenta, and it had completely disappeared by 76 days after the CS. The diagnosis of PG was promptly made in consultation with a plastic surgeon and a dermatologist when a wide ulcer emerged around the CS wound, and high-dose prednisolone was administered as treatment. At 90 days following the CS, near-complete epithelialization was achieved. This extremely rare case reflects the importance of rapid diagnosis and treatment of PG.
authors.affiliation: Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata City, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Nonaka
authors.affiliation: Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata City, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata City, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yamaguchi
authors.affiliation: Department of Dermatology, Niigata University Medical and Dental Hospital, Niigata City, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Aizawa
authors.affiliation: Department of Dermatology, Niigata University Medical and Dental Hospital, Niigata City, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujiwara
authors.affiliation: Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata City, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Enomoto
authors.affiliation: General Center for Perinatal, Maternal and Neonatal Medicine, Niigata University Medical and Dental Hospital, Niigata City, Japan. obgy@med.niigata-u.ac.jp.
authors.forename: Koichi
authors.initials: K
authors.lastname: Takakuwa
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D000072700:Conservative Treatment; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010921:Placenta Accreta / Q000601:surgery*; D010923:Placenta Previa / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis*; D011247:Pregnancy; D017511:Pyoderma Gangrenosum / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D014463:Ultrasonography
keywords: placenta previa with placenta accrete; placental retention; pyoderma gangrenosum