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

Actas Dermosifiliogr. 2016 Apr;107(3):e13-7. doi: 10.1016/j.ad.2015.04.022. Epub 2015 Nov 25.
[Article in English, Spanish]

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.

Keywords: Estoma; Periestomal; Peristomal; Pioderma gangrenoso; Pyoderma gangrenosum; Stroma; Tacrolimus; Tacrolimus.; Tratamiento; Treatment.

Publication types

  • Case Reports

MeSH terms

  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Inflammatory Bowel Diseases / complications
  • Pyoderma Gangrenosum / diagnosis*
  • Pyoderma Gangrenosum / drug therapy*
  • Rectal Neoplasms / complications
  • Risk Factors
  • Tacrolimus / therapeutic use*

Substances

  • Immunosuppressive Agents
  • Tacrolimus