ReportsParastomal pyoderma gangrenosum: Clinical features and management☆,☆☆
Section snippets
Patients
Ethical approval for the study was obtained from the Salford and Trafford local research ethics committee. Five hundred patients who had stoma surgery performed between 1994 and 1998 were approached by postal questionnaire and invited to attend for assessment of any parastomal skin problems. For this purpose a weekly clinic was set up and attended by two stoma nurses and a dermatologist. Of 300 surviving patients with persisting stomas, 175 (58%) replied to the questionnaire; 131 reported a
Results
PPG was identified in 5 of the patients from the questionnaire-based cohort. Three of these had occurred during the year 1998, indicating an annual incidence of at least 0.6% (3 of 500). No inferences regarding incidence could be made from the other 21 patients with PPG referred to the clinic because we had declared an interest in parastomal ulceration, thus introducing a selection bias.
The personal details, medical histories, results of investigations, and responses to treatment are shown in
Discussion
Nonhealing, noninfective ulceration consistent with PG is a cause of significant morbidity in stoma patients. In addition to pain and discomfort, the ulceration, together with bleeding or exudate, impairs stoma bag adhesion, causing leaks which are socially disabling for many patients.
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Postoperative and Peristomal Pyoderma Gangrenosum: Subtypes of Pyoderma Gangrenosum
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2023, Clinical Gastroenterology and HepatologyDiagnosis and management of peristomal pyoderma gangrenosum: A systematic review
2018, Journal of the American Academy of DermatologyCitation Excerpt :A 2-piece pouch system minimizes disruption to skin reepithelialization and ensures appropriate intervals of pouch changes.68 Proper ostomy appliance fit prevents leakage of intestinal contents on the surrounding skin.20 A diagnosis of PPG is made clinically yet requires the exclusion of other causes.
Clinical features, causes, treatments, and outcomes of peristomal pyoderma gangrenosum (PPG) in 44 patients: The Mayo Clinic experience, 1996 through 2013
2016, Journal of the American Academy of DermatologyPostoperative Pyoderma Gangrenosum: A Clinical Review of Published Cases
2016, Mayo Clinic ProceedingsCitation Excerpt :Operative trauma and pathergy, likely through up-regulation of neutrophils, seem to be the additional driving forces in PPG. Peristomal PG with local environmental irritation may have a different mechanism than the other subtypes; hence, it was excluded from this study.160-163 The term pathergic PG, named for the phenomenon of pathergy shown in PG lesions at sites of trauma, is often used interchangeably with PPG in the literature (Figure 2).41,93,149,164,165