Lyon CC, Smith AJ, Beck MH, Wong GA, Griffiths CE, et al.
Journal of the American Academy of Dermatology. Date of publication 2000 Jun 1;volume 42(6):992-1002.
1. J Am Acad Dermatol. 2000 Jun;42(6):992-1002.
Parastomal pyoderma gangrenosum: clinical features and management.
Lyon CC(1), Smith AJ, Beck MH, Wong GA, Griffiths CE.
Author information:
(1)Dermatology Centre, University of Manchester Medical School, Hope Hospital,
Salford, United Kingdom.
BACKGROUND: The importance of pyoderma gangrenosum (PG) as a cause of ulceration
around abdominal stomas is not well recognized.
OBJECTIVE: Our purpose was to describe the incidence, clinical and histologic
features, disease associations, and possible risk factors for parastomal PG.
METHODS: A clinic, run by a dermatologist and two stoma nurses, was created. Five
hundred patients approached by postal questionnaire were invited to attend if
they had skin problems. In addition, local surgical, dermatologic, and nursing
services were invited to refer patients with parastomal skin problems. Cases of
parastomal PG were identified, investigated, and treated.
RESULTS: The annual incidence of parastomal PG in the questionnaire-based cohort
of patients was 0.6% (3 patients). An additional 23 patients with the condition
were seen. No consistent hematologic, biochemical, immunologic, microbiological
or histologic abnormalities were identified. Local skin damage did not appear to
be an important trigger for parastomal PG. The condition is recurrent in one
third of cases. Topical tacrolimus (0.3% in carmellose sodium paste) has been
effective in 4 patients.
CONCLUSION: Parastomal PG is far more common than previous reports would suggest,
and it may be associated with diseases other than inflammatory bowel disease.
PMID: 10827402 [Indexed for MEDLINE]
