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CASE REPORT
Challenge of diagnosing pyoderma gangrenosum after caesarean section
  1. Philipp Foessleitner1,
  2. Ulrike Just2,
  3. Herbert Kiss1 and
  4. Alex Farr1
  1. 1 Department of Obstetrics and Gynecology, Medizinische Universität Wien, Vienna, Austria
  2. 2 Department of Dermatology, Medizinische Universitat Wien, Vienna, Austria
  1. Correspondence to Professor Alex Farr, alex.farr{at}meduniwien.ac.at

Abstract

Pyoderma gangrenosum is a neutrophilic skin disease that leads to extensive, painful, necrotic ulcerations, particularly at surgical sites. As obstetric cases with pyoderma gangrenosum are rare and, therefore, often misdiagnosed initially, it is important to raise awareness about this rare complication. Here, we describe a patient who presented with pyoderma gangrenosum at the surgical site 4 days after undergoing a caesarean section. The erythema was initially misdiagnosed as wound infection, and the patient, who was experiencing pain, underwent antibiotic treatment and surgical wound debridement. When the wound was unresponsive to these treatments, a dermatologist was consulted who suspected pyoderma gangrenosum and began a high-dose corticosteroids therapy, which led to a fulminant improvement of the local wound. In conclusion, the rare diagnosis of pyoderma gangrenosum should be considered in the differential diagnosis of a suspected surgical wound infection. Early interdisciplinary treatment is essential to avoid further complications.

  • obstetrics and gynaecology
  • dermatology
  • surgery
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Footnotes

  • Contributors This case report was written by PF, UJ, HK and AF. PF and AF were responsible for the overall content as guarantors, conceived of the idea for this article and performed the literature research. HK gave input on obstetrical treatment and outcome. UJ was responsible for writing the dermatological section and provided information of the patient’s follow-up.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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