Ohmaru-Nakanishi Takako, Goto Haruka, Maehara Miyako, Oishi Hiroko, Ueoka Yosuke
Department of Obstetrics and Gynecology, Hamanomachi Hospital, Nagahama 3-1-1, Fukuoka, Japan 810-8539, Japan.
Case Rep Womens Health. 2019 Mar 7;22:e00102. doi: 10.1016/j.crwh.2019.e00102. eCollection 2019 Apr.
Pyoderma gangrenosum is a rare ulcerating neutrophilic dermatosis. We describe the case of a 28-year-old woman with pyoderma gangrenosum in the perineal region during pregnancy. Cytological analysis of a skin biopsy specimen showed neutrophilic infiltrates across all the layers of the dermis, confirming the diagnosis of pyoderma gangrenosum. Determining a management plan, including the mode of delivery, was difficult. Oral prednisolone was started and her ulcer started to improve, but she still had the ulcer when she reached full term. Because there was a concern that the ulcer would be worsened by vaginal delivery, cesarean section was performed. After her delivery, pyoderma gangrenosum had not appeared at the cesarean incision and the ulcer in the perineal region had improved. Obstetricians should be aware of pyoderma gangrenosum as a differential diagnosis when vulvar ulceration develops during pregnancy.
坏疽性脓皮病是一种罕见的溃疡性嗜中性皮肤病。我们描述了一名28岁妊娠期会阴区患坏疽性脓皮病的女性病例。皮肤活检标本的细胞学分析显示真皮各层均有嗜中性浸润，确诊为坏疽性脓皮病。制定包括分娩方式在内的治疗方案很困难。开始口服泼尼松龙，她的溃疡开始改善，但足月时仍有溃疡。由于担心经阴道分娩会使溃疡恶化，遂行剖宫产。产后，剖宫产切口处未出现坏疽性脓皮病，会阴区溃疡有所改善。产科医生在孕期出现外阴溃疡时应将坏疽性脓皮病作为鉴别诊断之一。
