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Peri-ileostomy pyoderma gangrenosum. Case report
Revista Espanola De Enfermedades Digestivas
|July 31, 2014
Summary
Pyoderma gangrenosum is a severe complication after stoma placement, often underdiagnosed. This case highlights successful treatment of peri-ileostomy pyoderma gangrenosum in an ulcerative colitis patient.
Area of Science:
- Gastroenterology
- Dermatology
- Surgical Complications
Background:
- Pyoderma gangrenosum (PG) is a severe ulcerative skin condition.
- It can manifest as a complication following ostomy surgery.
- Peri-ileostomy pyoderma gangrenosum (PPG) is an underdiagnosed entity.
Observation:
- A patient with ulcerative colitis (UC) developed PPG after pancoloproctectomy and permanent ileostomy.
- The condition presented as severe ulceration around the ileostomy site.
Findings:
- Treatment involved a multimodal approach: local wound care, optimized ostomy appliance fitting, topical tacrolimus, systemic corticosteroids, adalimumab, and antibiotics.
- The patient achieved satisfactory resolution of PPG within eight weeks.
Implications:
- This case underscores the importance of recognizing and managing PPG in patients with inflammatory bowel disease and ostomies.
- A comprehensive treatment strategy combining local, topical, and systemic therapies can lead to successful outcomes.
- Further research into the pathophysiology and optimal management of PPG is warranted.
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