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Recurrent Genital Herpes Triggering Ulcerative Pyoderma Gangrenosum
Shreya Deoghare1, Shailya Gupta1, Devayani Pol1
1Department of Dermatology, Venereology, and Leprosy, Dr. D. Y. Patil Medical College Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND.
Cureus
|July 28, 2023
Summary
Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis causing painful ulcers. This case shows genital PG aggravated by menstruation-triggered herpes, responding to antiviral and immunosuppressive treatments.
Area of Science:
- Dermatology
- Immunology
Background:
- Pyoderma gangrenosum (PG) is a neutrophilic dermatosis characterized by painful ulcers unresponsive to conventional treatments.
- Genital PG is uncommon and often misdiagnosed, potentially coexisting with sexually transmitted infections, leading to delayed treatment and increased morbidity.
Observation:
- A case of non-healing genital ulcers is presented, initially treated with antibiotics without improvement.
- Ulcers aggravated monthly with menstruation, suggesting a cyclical trigger.
- Herpes genital infection was identified as a pathergy factor for the monthly exacerbation of genital PG.
Findings:
- Menstruation triggered herpes genital infection, which acted as a pathergy for recurrent genital PG flares.
- The patient showed significant improvement with antiviral and immunosuppressive medications.
Implications:
- Highlights the importance of considering pathergy in genital PG, especially in cases with cyclical exacerbations.
- Suggests a potential role for antiviral therapy in managing genital PG triggered by herpes infections.
- Emphasizes the need for accurate diagnosis to avoid treatment delays and reduce patient morbidity.
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