Pioderma gangrenoso periestomal: presentación de 4 casos y revisión de los factores de riesgo y la respuesta terapéutica

BACKGROUND: Peristomal pyoderma gangrenosum (PPG) is a rare complication mainly associated with inflammatory bowel disease. Although it has also been found in patients with an ileostomy with rectal cancer, the best treatment options in this context have not been precisely elucidated. CASE: This case report describes the importance of a multidisciplinary treatment approach for a rare case of PPG around a protective ileostomy resulting from rectal cancer. CONCLUSIONS: Early diagnosis of PPG is imperative to avoid further extension of the lesion. Aggressive management with a multidrug treatment, both topical and systemic, is recommended in severe cases. Close monitoring of the response is necessary, given the variability in the effectiveness of the treatments.

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Peristomal Pyoderma Gangrenosum in a Rectal Cancer Patient With an Ileostomy

Santacruz

Bermúdez

Sanz

et al. 2020

Journal of Wound, Ostomy &Amp; Continence Nursing

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

Vallini

Andreini

Bonadio

2017

The International Journal of Lower Extremity Wounds

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Pyoderma gangrenosum (PG) is a rare neutrophilic inflammatory skin disease, characterized by recurrent skin ulcers, which in almost 50% of cases are associated with systemic autoimmune disorders, including rheumatoid arthritis, chronic hepatitis, inflammatory bowel disease, paraproteinemias and hematological malignancies. A systematic search of literature for PG was carried out using the PubMed, Embase, and Google Scholar databases for the purpose of this review and 2780 articles were retrieved up to February 2017. Inflammation represents the predominant aspect of the disease, but its pathophysiological mechanisms are not completely clear yet, since there are many studies showing only one or more isolated findings of the disease. The goal of PG treatment is to reduce inflammation in order to promote ulcer healing by minimizing side effects of therapy. Several systemic and local treatments are available, but the lack of large randomized double-blind studies results in an absence of a uniform therapeutic standard: thus, more clinical studies are required in order to make head-to-head comparisons between combination and single-drug therapies and to identify specific combination therapies for distinctive clinical patterns of PG.

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Pioderma gangrenoso periestomal: presentación de 4 casos y revisión de los factores de riesgo y la respuesta terapéutica

Cited by 2 publications

References 9 publications

Peristomal Pyoderma Gangrenosum in a Rectal Cancer Patient With an Ileostomy

Peristomal Pyoderma Gangrenosum in a Rectal Cancer Patient With an Ileostomy

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

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