Clinical Medicine Insights: Dermatology

Objective: Presentation of pyoderma gangraenosum (PG) as an important differential diagnosis for wound healing disorders after cesarian section. Adequate therapeutic regimens are discussed.

Case report: A 39-year-old woman developed a PG after cesarean section. A treatment with prednisolone and cyclosporine A was started. Within three days of treatment, the inflammatory process was significantly reduced. Serological inflammatory markers and fever dropped to normal levels. Due to the development of a pronounced arterial hypertension, dapsone was additionally applied to reduce glucocorticoids and cyclosporine A doses. Rapid normalisation of blood pressure without aggravation. Modern wound dressings helped to rapidly establish granulation and reepithelialization. The immense ulceration completely healed after six months of therapy.

Conclusion: PG is a potentially lethal disease and must be considered as an important differential diagnosis after abdominal surgery and cesarean section. Modern systemic and topical treatments help to treat PG successfully.