Pyoderma gangrenosum during pregnancy - treatment options revisited.

Background: Pyoderma gangrenosum (PG) is a rare, ulcerating neutrophilic dermatosis of unknown aetiology; PG during pregnancy is particularly rare. The disease is frequently associated with immune-mediated, inflammatory diseases.

Objective: Diagnosis of PG can be challenging and relies upon exclusion of other causes such as traumas, infections, vascular diseases or neoplasms. Treatment options during pregnancy are limited.

Methods: To evaluate current treatment options for PG during pregnancy, we present a case of multilocular PG during the patient's first trimester. In conjunction with a comprehensive review of previously published cases of PG during gravidity, we discuss available treatment modalities including immunosuppressants and TNFα inhibitors.

Results: Our patient highlights the importance of including PG as a potential differential diagnosis of cutaneous ulcers during gravidity. Treatment with systemic glucocorticoids is effective and safe for the health of the mother and the unborn.

Conclusion: In pregnant females, it is particularly important to diagnose PG and control disease activity due to the risk of pathergy and wound healing deficiencies during delivery and post-partum. A limited number of treatment options are available to date, which require a precise risk-benefit evaluation.