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Pyoderma gangrenosum following an unplanned caesarean section: a patient revisited
  1. Waseem Ghumra,
  2. Adam Gold and
  3. Richard Michael Azurdia
  1. Dermatology, Broadgreen Hospital, Liverpool, Liverpool, UK
  1. Correspondence to Dr Waseem Ghumra; w.ghumra{at}nhs.net

Abstract

A 35-year-old woman was referred urgently to the dermatology department because of significant wound breakdown 3 weeks following an emergency caesarean section. Examination revealed a full thickness, undermined ulcer spanning the width of the patient’s caesarean scar, exposing the patient’s uterus. Clinical appearances were consistent with pyoderma gangrenosum. The patient has a history of complicated pyoderma gangrenosum, having undergone skin grafts 14 years prior, for ulcers on her lower legs. That episode was the subject of a case report, published in the BMJ, in 2007. On this occasion, the patient was treated with oral corticosteroids, and ciclosporin based on its efficacy during her previous episode, which in conjunction with negative pressure wound therapy, resulted in complete re-epithelialisation of her ulcer within 6 months.

  • dermatology
  • wound care
  • obstetrics and gynaecology

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Footnotes

  • Contributors The patient was seen by myself on-call. RMA was the patient’s named consultant, and the consultant under whose care the patient was managed for the duration of her treatment. RMA approached the patient to enquire whether she would consent to being the subject of a published case report. The planning of the article was undertaken by myself (WG), AG and RMA; the content of the article was largely decided beforehand. While the majority of the written piece for submission was drafted by myself, all authors contributed significantly to the body of the text, and proof-read the final version for submission.

  • 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.

  • Patient consent for publication Obtained.

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

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