PMID- 32743854
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20210514
IS  - 1529-8019 (Electronic)
IS  - 1396-0296 (Linking)
VI  - 33
IP  - 6
DP  - 2020 Nov
TI  - Successful treatment of severe refractory post-cesarean pyoderma gangrenosum with 
      intravenous immunoglobulin.
PG  - e14121
LID - 10.1111/dth.14121 [doi]
AB  - Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by 
      rapidly progressing necrolytic ulceration of the skin. Proper treatment is 
      crucial since it can result in devastating consequences. First-line treatments 
      include systemic corticosteroids or cyclosporine. However, no standardized 
      treatment regimens for refractory cases exist and treatment outcomes are affected 
      by underlying conditions. PG after cesarean section, which is believed to occur 
      in association with underlying pregnancy- and parturition-related immune changes, 
      is extremely rare, and all reported cases in the literature have been 
      successfully treated with systemic or topical corticosteroids. We report a case 
      of a 32-year-old patient with severe PG occurring on her cesarean scar 3 days 
      after the cesarean delivery. Treatment with systemic corticosteroids and 
      first-line immunomodulatory agents resulted in insufficient response and serious 
      complications. Intravenous immunoglobulin (IVIG) was then initiated, and a rapid 
      clinical response was seen. Corticosteroid dose was gradually decreased and 
      ceased. IVIG infusion was continued for 3 months until complete recovery. 
      Reactivation was not observed in a 1-year follow-up period. Due to its cost, IVIG 
      infusion is less suitable as a first-line agent. However, IVIG may be an 
      important therapeutic option in resistant postpartum PG, in which first-line 
      agents have failed or led to complications.
CI  - (c) 2020 Wiley Periodicals LLC.
FAU - Gunduz, Kamer
AU  - Gunduz K
AD  - Medical Faculty, Department of Dermatology, Celal Bayar University, Manisa, 
      Turkey.
FAU - Gulbasaran, Fatmagul
AU  - Gulbasaran F
AUID- ORCID: 0000-0002-7550-6052
AD  - Medical Faculty, Department of Dermatology, Celal Bayar University, Manisa, 
      Turkey.
AD  - Department of Dermatology, Salihli State Hospital, Manisa, Turkey.
FAU - Hasdemir, Pinar Solmaz
AU  - Hasdemir PS
AD  - Medical Faculty, Department of Obstetrics and Gynecology, Celal Bayar University, 
      Manisa, Turkey.
FAU - Temiz, Peyker
AU  - Temiz P
AD  - Medical Faculty, Department of Pathology, Celal Bayar University, Manisa, Turkey.
FAU - Inanir, Isil
AU  - Inanir I
AD  - Medical Faculty, Department of Dermatology, Celal Bayar University, Manisa, 
      Turkey.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20200812
PL  - United States
TA  - Dermatol Ther
JT  - Dermatologic therapy
JID - 9700070
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 83HN0GTJ6D (Cyclosporine)
SB  - IM
MH  - Adrenal Cortex Hormones
MH  - Adult
MH  - Cesarean Section/adverse effects
MH  - Cyclosporine
MH  - Female
MH  - Humans
MH  - *Immunoglobulins, Intravenous
MH  - Pregnancy
MH  - *Pyoderma Gangrenosum/diagnosis/drug therapy/etiology
OTO - NOTNLM
OT  - cesarean section
OT  - intravenous immunoglobulin
OT  - postpartum
OT  - pyoderma gangrenosum
EDAT- 2020/08/04 06:00
MHDA- 2021/05/15 06:00
CRDT- 2020/08/04 06:00
PHST- 2020/04/22 00:00 [received]
PHST- 2020/07/17 00:00 [revised]
PHST- 2020/07/24 00:00 [accepted]
PHST- 2020/08/04 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2020/08/04 06:00 [entrez]
AID - 10.1111/dth.14121 [doi]
PST - ppublish
SO  - Dermatol Ther. 2020 Nov;33(6):e14121. doi: 10.1111/dth.14121. Epub 2020 Aug 12.