Peristomal pyoderma gangrenosum

Published: 04/30/2012

Authors: Kaiser AM

This 66 year old patient presented 40 years after proctocolectomy/ileostomy for ulcerative colitis, with a stoma stricture and fistula and required an exploration with creation of a new ileostomy. The intraoperative and histopathology findings were now consistent with Crohn’s disease. The patient later developed increasing pain and erosive changes around the ileostomy. The findings with deep geographic ulcerations are characteristic for peristomal pyoderma gangrenosum, the differential diagnosis includes allergic reactions to the appliance. The patient responded to topical steroids, but the condition may require infliximab or other immunosuppressive drugs.