Sergent F, Joly P, Gravier A, Verspyck E, Marpeau L
Clinique Gynécologique et Obstétricale, Pavillon Mère-Enfant, Cedex, France.
J Gynecol Obstet Biol Reprod (Paris). 2002 Sep;31(5):506-11.
We report an unusual case of pyoderma gangrenosum at 26 weeks gestation and review other cases reported in the literature in order to examine the underlying causes and determine the appropriate diagnostic and therapeutic approach to this uncommon skin disease. Patient and methods. The patient developed an acute abdominal syndrome at 26 weeks gestation (laparotomy was non contributive) followed by pyoderma gangrenosum of the abdominal wall. Seven other cases have been reported in the literature associating pyoderma gangrenosum with pregnancy. We analyzed the clinical findings in these cases.
Corticosteroid therapy successfully controlled pyoderma gangrenosum in our patient. Pregnancy outcome was favorable with little effect on the newborn. Complete healing was achieved after several months of treatment.
Histological lesions are nonspecific. Diagnosis of pyoderma gangrenosum is generally based on clinical signs. Systemic disease is associated in half the cases (inflammatory bowel disease, myelodysplastic syndrome, rheumatoid arthritis). The impact on pregnancy appears to be limited. Treatment is based on high-dose systemic corticosteroid therapy or cyclosporin. The two drugs may have to be combined. Search for an associated disease and appropriate treatment is particularly important for the outcome of pregnancy.
我们报告一例妊娠26周时发生的坏疽性脓皮病罕见病例，并回顾文献中报道的其他病例，以探究其潜在病因，并确定针对这种罕见皮肤病的适当诊断和治疗方法。患者与方法。该患者在妊娠26周时出现急性腹部综合征（剖腹探查无诊断价值），随后发生腹壁坏疽性脓皮病。文献中还报道了其他7例坏疽性脓皮病与妊娠相关的病例。我们分析了这些病例的临床发现。
皮质类固醇疗法成功控制了我们患者的坏疽性脓皮病。妊娠结局良好，对新生儿影响很小。经过数月治疗后实现了完全愈合。
组织学病变是非特异性的。坏疽性脓皮病的诊断通常基于临床体征。半数病例与全身性疾病相关（炎症性肠病、骨髓增生异常综合征、类风湿性关节炎）。对妊娠的影响似乎有限。治疗基于大剂量全身性皮质类固醇疗法或环孢素。这两种药物可能必须联合使用。寻找相关疾病并进行适当治疗对妊娠结局尤为重要。
