A Case Series of 4 Patients With Peristomal Pyoderma Gangrenosum: Review of Risk Factors and Treatment Response

Abstract

The literature on peristomal pyoderma gangrenosum (PPD) is scarce, and studies to date have included few patients. It is therefore difficult to determine the incidence of PPD, investigate risk factors, or evaluate the effectiveness of the different treatments available. We report on a series of 4 patients diagnosed with PPD at our hospital in 2013 and 2014, and review the clinical characteristics and responses to treatment. Three of the patients had inflammatory bowel disease and 1 had rectal cancer. Three patients responded favorably to initial treatment with 0.1% tacrolimus ointment (administered as monotherapy in 2 cases and combined with immunosuppressants in the other). However, on withdrawal of tacrolimus, the disease recurred in all 3 patients, requiring treatment reintroduction or modification.

Peristomal pyoderma gangrenosum: 12‐year experience in a single tertiary referral centre

“…( n = 20). The majority of other studies have been very small case series with 3–5 patients or case reports …”

Pyoderma Gangrenosum: A Current Problem as Much as an Unknown One

“…However, in addition to these main categories, PG can also occur in other specific forms, including those peristomal, 69-71 representing about 50% of all chronic peristomal ulcers, 72 genital, ocular, 73 mucosal, and postoperative.…”