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Parastomal pyoderma gangrenosum: clinical features and management.
C C Lyon1, A J Smith, M H Beck
1Dermatology Centre, University of Manchester Medical School, Hope Hospital, Salford, United Kingdom.
Journal of the American Academy of Dermatology
|May 29, 2000
Summary
Parastomal pyoderma gangrenosum (PG) is more common than previously thought. This study details its incidence, features, and treatment, finding topical tacrolimus effective for some patients.
Area of Science:
- Dermatology
- Gastroenterology
- Surgical Nursing
Background:
- Pyoderma gangrenosum (PG) is an underrecognized cause of ulceration around abdominal stomas.
- Parastomal PG requires further investigation into its incidence and characteristics.
Purpose of the Study:
- To determine the incidence of parastomal PG.
- To describe clinical, histologic, and association features of parastomal PG.
- To identify potential risk factors for parastomal PG.
Main Methods:
- Established a specialized clinic for parastomal skin issues.
- Surveyed 500 patients via postal questionnaire for skin problems.
- Referred patients with parastomal skin issues from surgical, dermatologic, and nursing services.
Main Results:
- Annual incidence of parastomal PG was 0.6% in the questionnaire cohort; 23 additional patients were identified.
- No consistent laboratory abnormalities or triggers like local skin damage were found.
- Recurrence observed in one-third of cases; topical tacrolimus showed efficacy in 4 patients.
Conclusions:
- Parastomal PG is more prevalent than previously reported.
- Associations with diseases beyond inflammatory bowel disease may exist.
- Further research is needed to understand parastomal PG fully.