Topical Therapy for Peristomal Pyoderma Gangrenosum

Abstract

Background: Pyoderma gangrenosum (PG) is an uncommon condition. Literature on the management of peristomal PG (PPG) is sparse. In the absence of randomized controlled trials the reporting of case series is potentially helpful to the management of this uncommon disease. Objective: In this study we report our experience with topical corticosteroid therapy for 14 consecutive cases of PPG. Methods: A clinical diagnosis PPG was made by a trained dermatologist using the appropriate investigations where necessary. Results: The majority of the cases presented were managed with simple topical corticosteroids, occasionally in combination with a change of dressing. In 8/14 (57%) cases ulcer resolution was achieved within 3 months with topical treatment alone or topical treatment plus a change of dressing to a silicone-based product applied directly to the wound under the normal base plate of the stoma bag. Conclusion: Our experience suggests that a significant proportion of PPG can be managed by topical treatment alone. The simple topical treatment allows the patient to continue use of stoma care products while minimizing the potential for side effects.