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Peri-ileostomy pyoderma gangrenosum. Case report

C Cerdán-Santacruz, M R Caparrós-Sanz, M Lancharro-Bermúdez

    Revista Espanola De Enfermedades Digestivas
    |July 31, 2014
    PubMed

    Insights

    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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