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Características clínicas y tratamiento de la pioderma peristomal gangrenosum
A P Hughes1, J M Jackson, J P Callen
1Division of Dermatology, Department of Medicine, University of Louisville School of Medicine, KY, USA. jefca@aol.com
JAMA
|September 23, 2000
Resumen
La piodermia peristomal gangrenosa (PPG) puede ocurrir sin enfermedad inflamatoria intestinal (EII). La reubicación del estoma puede conducir a nuevas úlceras, y el trauma puede desencadenar lesiones de PPG en individuos susceptibles.
Área de la Ciencia:
- Dermatología Dermatología dermatología.
- Gastroenterología y Gastroenterología.
- Oncología Quirúrgica Oncología Quirúrgica.
Sus antecedentes:
- La pioderma peristomal gangrenosa (PPG) es una rara variante de la pioderma gangrenosa.
- PPG se informa predominantemente en pacientes con enfermedad inflamatoria intestinal (EII).
- La GPP a menudo se diagnostica erróneamente, lo que lleva a un tratamiento retrasado o incorrecto.
Objetivo del estudio:
- Para definir las características clínicas de PPG.
- Para mejorar el diagnóstico de PPG.
- Para delinear estrategias de gestión efectivas para PPG.
Principales métodos:
- Análisis retrospectivo de 7 pacientes con GPP.
- Evaluación de los hallazgos clínicos e histopatológicos.
- Evaluación de los trastornos asociados y datos microbiológicos.
Principales resultados:
- PPG se produjo en pacientes con enfermedad de Crohn, colitis ulcerosa y cáncer abdominal.
- Cinco pacientes experimentaron una recaída de PPG después de la curación inicial.
- La reubicación del estoma resultó en nuevas ulceraciones; los corticosteroides tópicos y los agentes sistémicos fueron terapias efectivas.
Conclusiones:
- PPG puede manifestarse independientemente de la EII.
- La biopsia de piel es útil para excluir otras afecciones, pero no para diagnosticar la GPP.
- Evite la reubicación del estoma; el trauma puede precipitar las lesiones de PPG a través de la patergia.
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