Clinical features, causes, treatments, and outcomes of peristomal pyoderma gangrenosum (PPG) in 44 patients: The Mayo Clinic experience, 1996 through 2013.
Background: There are limited large case series of peristomal pyoderma gangrenosum (PPG), an uncommon cause of recalcitrant peristomal ulceration.Objective: We sought to further characterize the clinical features, causes, treatments, and outcomes of PPG.Methods: We conducted a retrospective chart re...
| Publicado en: | Journal of the American Academy of Dermatology Vol. 75; no. 5; pp. 931 - 940 |
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| Autores principales: | , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Elsevier B.V.
Nov2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=118813337&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 118813337 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01909622 1ZF jtl: Journal of the American Academy of Dermatology issn: 01909622 maglogo: N pubinfo: dt: Nov2016 vid: 75 iid: 5 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 118813337 118813337 NLM27473454 10.1016/j.jaad.2016.05.044 NLM27473454 118813337 ppf: 931 ppct: 9 formats: tig: atl: Clinical features, causes, treatments, and outcomes of peristomal pyoderma gangrenosum (PPG) in 44 patients: The Mayo Clinic experience, 1996 through 2013. aug: au: Barbosa, Naiara S. Tolkachjov, Stanislav N. el-Azhary, Rokea A. Davis, Mark D.P. Camilleri, Michael J. McEvoy, Marian T. Bridges, Alina G. Wetter, David A. affil: Department of Dermatology, Mayo Clinic, Rochester, Minnesota sug: subj: Pyoderma Gangrenosum Etiology Postoperative Complications Etiology Ostomy Adverse Effects Adult Pyoderma Gangrenosum Surgery Female Pyoderma Gangrenosum Epidemiology Postoperative Complications Epidemiology Immunosuppressive Agents Adverse Effects Skin Ulcer Etiology Risk Factors Retrospective Design Antibiotics Therapeutic Use Biological Products Adverse Effects Male Immunoglobulins, Intravenous Therapeutic Use Inflammatory Bowel Diseases Surgery Skin Ulcer Epidemiology Adolescence Aged, 80 and Over Drug Therapy, Combination Middle Age Pyoderma Gangrenosum Diagnosis Postoperative Complications Drug Therapy Diagnostic Errors Adrenal Cortex Hormones Therapeutic Use Immunocompromised Host Recurrence Postoperative Complications Surgery Aged Disease Susceptibility Young Adult Reoperation Skin Ulcer Drug Therapy Biological Products Therapeutic Use Pyoderma Gangrenosum Drug Therapy Scales Adult: 19-44 years Adolescent: 13-18 years Aged, 80 & over Middle Aged: 45-64 years Aged: 65+ years Female Male ab: Background: There are limited large case series of peristomal pyoderma gangrenosum (PPG), an uncommon cause of recalcitrant peristomal ulceration.Objective: We sought to further characterize the clinical features, causes, treatments, and outcomes of PPG.Methods: We conducted a retrospective chart review of patients with PPG seen at Mayo Clinic from January 1996 to July 2013.Results: A total of 44 patients had PPG (mean age, 46 years; 32 women [73%]); 41 (93%) had inflammatory bowel disease. Mean time to PPG onset after stoma surgery was 5.2 months (excluding 1 outlier). Systemic therapies included corticosteroids (66%), immunosuppressants (41%), biologics (36%), and a combination of systemic treatments (36%). Mean time to reach a complete response was 10.7 weeks. Stoma closure had the greatest complete response (4 of 4 patients, no recurrences). Recurrence after any treatment was documented in 23 of 38 (61%) patients. Stoma relocation/revision recurred in 10 of 15 (67%) patients. Remission occurred in 29 of 31 (94%) patients.Limitations: Small sample size and retrospective study design are limitations.Conclusion: PPG is strongly associated with inflammatory bowel disease, is predominant in women, and has a prolonged time to onset and high recurrence rate. Systemic corticosteroid or combination therapies and surgical closure can be effective treatments. Timely recognition and management are paramount to achieving early remission. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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