Peristomal Dermatology

Donna Loehner; Kerry Casey; David J. Schoetz Jr

doi:10.1055/s-2002-34274

Clinics in Colon and Rectal Surgery, Table of Contents

Clin Colon Rectal Surg 2002; 15(3): 209-214
DOI: 10.1055/s-2002-34274

Peristomal Dermatology

Donna Loehner, Kerry Casey, David J. Schoetz Jr.

Department of Colon and Rectal Surgery, Lahey Clinic, Burlington, MA

Abstract

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

Full Text

References

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
2 Dorland's Illustrated Medical Dictionary. 25th edition. Philadelphia: W.B. Saunders 1974: 425
3 Abrams J S. Abdominal stomas: indications for operative techniques and patient care. Boston, MA: PSG Publishing 1984: 121
4 Sparberg M. Ileostomy Care. Springfield, IL: Charles C. Thomas Publishing Co 1971: 68
5 Erwin-Toth P. Prevention and management of peristomal skin complications. Adv Skin Wound Care . 2001; 1-6
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
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
8 Maklebust J. Pressure ulcers: Etiology and prevention. Nurs Clin North Am . 1987; 22 359-378
9 Hampton B. Peristomal and stomal complications. In: Hampton B, Bryant R, eds. Ostomies and Continent Diversions: Nursing Management St. Louis:Mosby 1992: 108
10 Abrams J S. Abdominal stomas: Indications for operative techniques and patient care. Boston:PSG Publishing 1984: 121
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
12 Perry H O. Pyoderma gangrenosum. South Med J . 1969; 62 899-908
13 Sparberg M, Fennessy J, Kirsner J B. Ulcerative proctitis and mild ulcerative colitis: A study of 220 patients. Medicine . 1966; 45 391-412
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
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
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
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
18 Callen J P, Taylor W B. Pyoderma gangrenosum: A literature review. Cutis . 1978; 21 61-64
19 Basler R SW. Ulcerative colitis and the skin. Med Clin North Am . 1980; 64 941-954
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
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
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
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
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
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
26 Wolfsen H C, Brubacher L L, Ng C S. Refractory parastomal ulcers: A multidisciplinary approach. J Clin Gastroenterol . 1990; 12 651-655
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
28 Cuttino C. Pyoderma gangrenosum: An innovative wound care protocol. J Enterostomal Ther . 1987; 14 216-219
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
31 Cave D R, Burakoff R. Pyoderma gangrenosum associated with ulcerative colitis: Treatment with disodium cromoglycate. Am J Gastroenterol . 1987; 82 802-804
32 Moschella S L. Pyoderma gangrenosum: A patient successfully treated with intralesional injections of steroid. Arch Dermatol . 1967; 95 121-123
33 Goldstein F, Krain R, Thornton J J. Intralesional steroid therapy of pyoderma gangrenosum. J Clin Gastroenterol . 1985; 7 499-501
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
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
36 Jolles S, Niclasse S, Benson E. Combination oral and topical tacrolimus in therapy-resistant pyoderma gangrenosum. Br J Dermatol . 1999; 140 562-564