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Crushed Corticosteroid Tablets in Peristomal Pyoderma Gangrenosum: A Case Report
Martina Burlando1,2,3,4,5, Andrea Paravisi1,2,3,4,5, Giorgia Bodini1,2,3,4,5
1Martina Burlando, MD, Dermatology Unit, Policlinico San Martino Hospital, Genova, Italy.
Summary
Peristomal pyoderma gangrenosum (PPG) is a rare skin condition. Topical corticosteroid tablets effectively treated a refractory PPG case, reducing pain and improving ostomy appliance adherence.
Area of Science:
- Dermatology
- Gastroenterology
Background:
- Peristomal pyoderma gangrenosum (PPG) is a variant of pyoderma gangrenosum (PG).
- PPG arises from a pathergy response to ostomy-related trauma or adhesive removal.
- No current evidence-based guidelines exist for PPG management.
Observation:
- A 39-year-old woman with Crohn's disease and multiple ileostomies developed refractory PPG.
- The patient failed treatment with adalimumab and multiple surgical interventions.
- Topical application of crushed prednisone tablets was initiated.
Findings:
- Crushed corticosteroid tablets demonstrated a dramatic and successful treatment response in refractory PPG.
- This topical therapy effectively reduced patient pain.
- Improved pain management facilitated better ostomy appliance adhesion.
Implications:
- Crushed corticosteroid tablets offer a novel, effective therapeutic option for managing peristomal pyoderma gangrenosum.
- This approach may be beneficial for patients refractory to standard treatments.
- Further research into topical corticosteroid efficacy for PPG is warranted.
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