Diagnosis and management of peristomal pyoderma gangrenosum: A systematic review.
Background: Peristomal pyoderma gangrenosum (PPG) is an uncommon subtype of pyoderma gangrenosum. PPG is a challenging condition to diagnose and treat; no evidence-based guidelines exist.Objective: We sought to identify important clinical features of PPG and effective treatments available for its ma...
| Publicado en: | Journal of the American Academy of Dermatology Vol. 78; no. 6; pp. 1195 - 1196 |
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| Autores principales: | , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
Jun2018
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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=129564659&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 129564659 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: Jun2018 vid: 78 iid: 6 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 129564659 129564659 NLM29288099 129564659 10.1016/j.jaad.2017.12.049 NLM29288099 129564659 ppf: 1195 ppct: 1 formats: tig: atl: Diagnosis and management of peristomal pyoderma gangrenosum: A systematic review. aug: au: Afifi, Ladan Sanchez, Isabelle M. Wallace, Matthew M. Braswell, Sara F. Ortega-Loayza, Alex G. Shinkai, Kanade affil: Department of Dermatology, University of California, San Francisco, San Francisco, California sug: subj: Skin Care Methods Pyoderma Gangrenosum Therapy Enterostomy Adverse Effects Pyoderma Gangrenosum Diagnosis Ostomy Adverse Effects Postoperative Complications Therapy Female Crohn Disease Surgery Adrenal Cortex Hormones Therapeutic Use Human Reoperation Methods Male Pyoderma Gangrenosum Etiology Biological Products Therapeutic Use Antibiotics Therapeutic Use Prognosis Postoperative Complications Diagnosis Drug Therapy, Combination Colitis, Ulcerative Surgery Disease Management Female Male ab: Background: Peristomal pyoderma gangrenosum (PPG) is an uncommon subtype of pyoderma gangrenosum. PPG is a challenging condition to diagnose and treat; no evidence-based guidelines exist.Objective: We sought to identify important clinical features of PPG and effective treatments available for its management.Methods: A systematic literature review of PPG was performed using PubMed, Medline, and Embase databases.Results: We describe 335 patients with PPG from 79 studies. Clinical features include a painful, rapidly progressing ulcer with undermined, violaceous borders with a history of ostomy leakage and local skin irritation or trauma. Systemic steroids are first-line therapy; infliximab and adalimumab provide concomitant control of active inflammatory bowel disease. Combination local and systemic therapy was commonly used. Wound dressings, vehicle selection, and appropriate ostomy devices to minimize leakage, irritation, and pressure-induced ischemia can improve healing. Distinct from classic ulcerative pyoderma gangrenosum, surgical approaches, such as stoma closure and resection of active inflammatory bowel disease, have an effective role in PPG management.Limitations: PPG is a rare disease lacking randomized trials or diagnostic guidelines. Treatment duration and follow-up time among studies are variable.Conclusions: Key clinical characteristics of PPG are highlighted. Several treatments, including a more prominent role for surgical intervention, may be effective for PPG treatment. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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