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Clinical characteristics of peristomal pyoderma gangrenosum: A Single Center Retrospective Observational Study
Masaru Honma1, Motoshi Sugawara1, Naomi Ueno2
1Department of Dermatology, Asahikawa Medical University Hospital, Asahikawa, Japan.
Abstract:
Peristomal pyoderma gangrenosum (PPG), a variant of pyoderma gangrenosum, occurs adjacent to intestinal or urinary stomas and are typically seen in patients with active inflammatory bowel diseases (IBD). The present study evaluated 14 cases of PPG among 537 patients that had undergone ostomy surgery at Asahikawa Medical University Hospital from January 2017 to December 2021. The incidence of PPG among ostomy cases was calculated as 1.01 per 100-person-years. The median period from ostomy surgery to PPG onset was 192.5 days (36-1224 days). Significant differences in gender and ostomy subtype were observed in patients with PPG compared to all patients that had undergone ostomy surgery. IBD prevalence was comparable between groups. Topical corticosteroids or tacrolimus were sufficient for controlling PPG lesions in all cases other than one case controlled with oral prednisolone administered for a separate condition. Clinicians should be aware of recent developments in IBD therapies that may modify the risk of developing PPG. The present study results add to current knowledge of the pathogenesis of PPG.
Insights
Peristomal pyoderma gangrenosum (PPG) affects ostomy patients, with an incidence of 1.01 per 100-person-years. Most cases responded well to topical treatments, highlighting awareness of evolving inflammatory bowel disease therapies.
Area of Science:
- Dermatology
- Gastroenterology
- Surgical Oncology
Background:
- Peristomal pyoderma gangrenosum (PPG) is a rare inflammatory skin condition occurring around ostomy sites.
- PPG is often associated with underlying inflammatory bowel diseases (IBD).
Purpose of the Study:
- To evaluate the incidence, clinical characteristics, and treatment outcomes of peristomal pyoderma gangrenosum (PPG) in ostomy patients.
- To identify potential risk factors and associations related to PPG development.
Main Methods:
- Retrospective analysis of 14 PPG cases among 537 ostomy surgery patients (January 2017 - December 2021).
- Calculation of PPG incidence and time to onset post-surgery.
- Comparison of demographic and clinical data between PPG patients and the general ostomy population.
Main Results:
- PPG incidence was 1.01 per 100-person-years, with a median onset of 192.5 days post-ostomy.
- Significant differences in gender and ostomy subtype were noted in PPG patients.
- Most PPG cases were effectively managed with topical corticosteroids or tacrolimus.
Conclusions:
- PPG is a distinct clinical entity in ostomy patients, with specific demographic and surgical associations.
- Topical therapies are generally effective for PPG management.
- Clinicians should consider the impact of novel IBD treatments on PPG risk.
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