Martina Burlando, MD, Dermatology Unit, Policlinico San Martino Hospital, Genova, Italy.
Andrea Paravisi, MD, Dermatology Unit, Policlinico San Martino Hospital, Genova, Italy.
J Wound Ostomy Continence Nurs. 2021;48(5):460-462. doi: 10.1097/WON.0000000000000798.
Peristomal pyoderma gangrenosum (PPG) is a variant of pyoderma gangrenosum (PG). It results from a pathergy response to trauma from effluent from the ostomy or secondary to trauma caused by removal of the ostomy appliance adhesive in contact with the skin. Currently, no evidence-based guidelines for the management of PPG exist. This case study reports a dramatic response to crushed corticosteroid tablets in a patient who proved refractory to first- and second-line treatments of her PPG and several surgeries.
Ms T. was a 39-year-old woman with Crohn's disease who underwent several ileostomies, developed PPG, and failed treatment with adalimumab. Her PPG was successfully treated topically with crushed prednisone tablets.
We found that crushed corticosteroid tablets were an effective treatment of PPG, due to the ability to reduce pain and allow adhesion of the ostomy appliance.
肠造口周围坏疽性脓皮病（PPG）是坏疽性脓皮病（PG）的一种变体。它是由造口流出物对创伤的过敏反应引起的，或者继发于与皮肤接触的造口袋器械粘胶去除引起的创伤。目前，尚无针对 PPG 管理的循证指南。本病例报告了一例患者对压碎的皮质类固醇片剂的显著反应，该患者对 PPG 的一线和二线治疗以及多次手术均无反应。
T 女士，39 岁，患有克罗恩病，曾接受过几次回肠造口术，发生 PPG，并对阿达木单抗治疗无反应。她的 PPG 成功地用压碎的泼尼松片剂进行了局部治疗。
我们发现，压碎的皮质类固醇片剂是治疗 PPG 的有效方法，因为它可以减轻疼痛并允许造口袋器械粘附。
