Download PDF
Clin Colon Rectal Surg 2002; 15(3): 209-214
DOI: 10.1055/s-2002-34274
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Peristomal Dermatology

Donna Loehner, Kerry Casey, David J. Schoetz Jr.
  • Department of Colon and Rectal Surgery, Lahey Clinic, Burlington, MA
Further Information

Publication History

Publication Date:
20 September 2002 (online)

Also available at
    Permissions and Reprints

ABSTRACT

Inflammatory conditions affecting the skin around an intestinal stoma are common and may be a source of considerable aggravation to patients so affected. Recognition and prompt appropriate treatment of these conditions improves the quality of life for ostomates suffering from these problems. Peristomal pyoderma gangrenosum represents an unusual peristomal skin condition that is difficult to treat; appropriate management often requires diagnosis and therapy of underlying inflammatory bowel disease.

KEYWORDS

Intestinal stomas - pyoderma gangrenosum

REFERENCES

  • 1 Lyons C C, Smith A J, Griffiths C EM, Beck M H. The spectrum of skin disorders in abdominal stoma patients.  Br J Derm . 2000;  143 1248-1260
    PubMedSearch in Google Scholar
  • 2 Dorland's Illustrated Medical Dictionary.  25th edition. Philadelphia: W.B. Saunders 1974: 425
    Search in Google Scholar
  • 3 Abrams J S. Abdominal stomas: indications for operative techniques and patient care.  Boston, MA: PSG Publishing 1984: 121
    Search in Google Scholar
  • 4 Sparberg M. Ileostomy Care. Springfield, IL: Charles C. Thomas Publishing Co 1971: 68
    Search in Google Scholar
  • 5 Erwin-Toth P. Prevention and management of peristomal skin complications.  Adv Skin Wound Care . 2001;  1-6
    PubMedSearch in Google Scholar
  • 6 Fry R D, Swatske M E. Skin problems in stoma management. In: MacKeigan JM, Cataldo PA, eds. Intestinal Stomas: Principles and Procedures of Stoma Management St. Louis: Quality Medical Publishing, Inc 1993: 329-338
    Search in Google Scholar
  • 7 Erwin-Toth P, Doughty D B. Principles and procedures of stomal management. In: Hampton BG, Bryant RA, eds. Ostomies and Continent Diversions St. Louis:Mosby 1992: 29-103
    Search in Google Scholar
  • 8 Maklebust J. Pressure ulcers: Etiology and prevention.  Nurs Clin North Am . 1987;  22 359-378
    PubMedSearch in Google Scholar
  • 9 Hampton B. Peristomal and stomal complications. In: Hampton B, Bryant R, eds. Ostomies and Continent Diversions: Nursing Management St. Louis:Mosby 1992: 108
    Search in Google Scholar
  • 10 Abrams J S. Abdominal stomas: Indications for operative techniques and patient care. Boston:PSG Publishing 1984: 121
    Search in Google Scholar
  • 11 Brunsting L A, Goeckerman W H, O'Leary P A. Pyoderma (ecthyma) gangrenosum: Clinical and experimental observations in five cases occurring in adults.  Arch Dermatol . 1930;  22 655-680
    PubMedSearch in Google Scholar
  • 12 Perry H O. Pyoderma gangrenosum.  South Med J . 1969;  62 899-908
    PubMedSearch in Google Scholar
  • 13 Sparberg M, Fennessy J, Kirsner J B. Ulcerative proctitis and mild ulcerative colitis: A study of 220 patients.  Medicine . 1966;  45 391-412
    PubMedSearch in Google Scholar
  • 14 Schoetz D J, Coller J A, Veidenheimer M C. Pyoderma gangrenosum and Crohn's disease: Eight cases and a review of the literature.  Dis Colon Rectum . 1983;  26 155-158
    PubMedSearch in Google Scholar
  • 15 Greenstein A J, Janowitz H D, Sachar D B. The extra-intestinal complications of Crohn's disease and ulcerative colitis: A study of 700 patients.  Medicine . 1976;  55 401-412
    CrossrefPubMedSearch in Google Scholar
  • 16 Talansky A L, Meyers S, Greenstein A J, Janowitz H D. Does intestinal resection heal the pyoderma gangrenosum of inflammatory bowel disease?.  J Clin Gastroenterol . 1983;  5 207-210
    PubMedSearch in Google Scholar
  • 17 Mir-Madjlessi S H, Taylor J S, Farmer R G. Clinical course and evolution of erythema nodosum and pyoderma gangrenosum in chronic ulcerative colitis: A study of 42 patients.  Am J Gastroenterol . 1985;  80 615-620
    PubMedSearch in Google Scholar
  • 18 Callen J P, Taylor W B. Pyoderma gangrenosum: A literature review.  Cutis . 1978;  21 61-64
    PubMedSearch in Google Scholar
  • 19 Basler R SW. Ulcerative colitis and the skin.  Med Clin North Am . 1980;  64 941-954
    PubMedSearch in Google Scholar
  • 20 Powell F C, Schroeter A L, Su W PD, Perry H O. Pyoderma gangrenosum: A review of 86 patients.  Q J Med . 1985;  55 173-186
    PubMedSearch in Google Scholar
  • 21 Levitt M D, Ritchie J K, Lennard-Jones J E, Phillips R KS. Pyoderma gangrenosum in inflammatory bowel disease.  Br J Surg . 1991;  78 676-678
    PubMedSearch in Google Scholar
  • 22 Klein J D, Biller J A, Leape L L, Grand R J. Pyoderma gangrenosum occurring in multiple surgical incision sites.  Gastroenterology . 1987;  92 810-813
    PubMedSearch in Google Scholar
  • 23 Margoles J S, Wenger J. Stomal ulceration associated with pyoderma gangrenosum and chronic ulcerative colitis: Report of two cases.  Gastroenterology . 1961;  41 594-598
    PubMedSearch in Google Scholar
  • 24 McGarity W C, Robertson D B, McKeown P P. Pyoderma gangrenosum at the parastomal site in patients with Crohn's disease.  Arch Surg . 1984;  119 1186-1188
    CrossrefPubMedSearch in Google Scholar
  • 25 Last M, Fazio V, Lavery I, Jagelman D. Conservative management of paraileostomy ulcers in patients with Crohn's disease.  Dis Colon Rectum . 1984;  27 779-786
    PubMedSearch in Google Scholar
  • 26 Wolfsen H C, Brubacher L L, Ng C S. Refractory parastomal ulcers: A multidisciplinary approach.  J Clin Gastroenterol . 1990;  12 651-655
    PubMedSearch in Google Scholar
  • 27 Sheldon D G, Sawchuk L L, Kozarek R A, Thirlby R C. Twenty cases of peristomal pyoderma gangrenosum: Diagnostic implications and management.  Arch Surg . 2000;  135 564-569
    CrossrefPubMedSearch in Google Scholar
  • 28 Cuttino C. Pyoderma gangrenosum: An innovative wound care protocol.  J Enterostomal Ther . 1987;  14 216-219
    PubMedSearch in Google Scholar
  • 29 Hess C. Nurse's Clinical Guide to Wound Care. 2nd ed. Springhouse, PA: Springhouse Corp, 1998,363
  • 30 Saffouri B, Hom B M, Mertesdorf J M, Gardiner J E. Treatment of pyoderma gangrenosum with disodium cromoglycate.  Dig Dis Sci . 1984;  29 183-185
    PubMedSearch in Google Scholar
  • 31 Cave D R, Burakoff R. Pyoderma gangrenosum associated with ulcerative colitis: Treatment with disodium cromoglycate.  Am J Gastroenterol . 1987;  82 802-804
    PubMedSearch in Google Scholar
  • 32 Moschella S L. Pyoderma gangrenosum: A patient successfully treated with intralesional injections of steroid.  Arch Dermatol . 1967;  95 121-123
    CrossrefPubMedSearch in Google Scholar
  • 33 Goldstein F, Krain R, Thornton J J. Intralesional steroid therapy of pyoderma gangrenosum.  J Clin Gastroenterol . 1985;  7 499-501
    PubMedSearch in Google Scholar
  • 34 Matis W L, Ellis C N, Griffiths C E, Lazarus G S. Treatment of pyoderma gangrenosum with cyclosporine.  Arch Dermatol . 1992;  128 1060-1064
    PubMedSearch in Google Scholar
  • 35 Capella G L, Frigerio E, Fracchiolla C, Altomare G. The simultaneous treatment of inflammatory bowel diseases and associated pyoderma gangrenosum with oral cyclosporin A.  Scand J Gastroenterol . 1999;  34 220-221
    CrossrefPubMedSearch in Google Scholar
  • 36 Jolles S, Niclasse S, Benson E. Combination oral and topical tacrolimus in therapy-resistant pyoderma gangrenosum.  Br J Dermatol . 1999;  140 562-564
    CrossrefPubMedSearch in Google Scholar