Topical Management of Peristomal Pyoderma Gangrenosum: A Report of 3 Case Studies.

BACKGROUND: Peristomal pyoderma gangrenosum (PPG) presents multiple challenges for healthcare providers. The diagnosis of PPG may be delayed, and it may be mistaken for an irritant dermatitis or an infection. Patients with ostomies secondary to inflammatory bowel disease (IBD) may experience PPG. Is...

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Publicado en:Journal of Wound, Ostomy & Continence Nursing Vol. 48; no. 4; pp. 345 - 350
Autores principales: Toyoda, Tomohiro, Mitsuyama, Shinji, Nagao, Eri, Abe, Fumihito, Kimura, Masaaki, Seido, Yurie, Higuchi, Tetsuya
Formato: case study pictorial Journal Article
Publicado: Lippincott Williams & Wilkins Jul/Aug2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul/Aug2021
      vid: 48
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        atl: Topical Management of Peristomal Pyoderma Gangrenosum: A Report of 3 Case Studies.
      aug:
        au:
          Toyoda, Tomohiro
          Mitsuyama, Shinji
          Nagao, Eri
          Abe, Fumihito
          Kimura, Masaaki
          Seido, Yurie
          Higuchi, Tetsuya
        affil: Tomohiro Toyoda, MD, Department of Dermatology, Toho University Sakura Medical Center, Sakura, Japan.
      sug:
        subj:
          Pyoderma Gangrenosum Prevention and Control
          Peristomal Skin Care
          Administration, Topical
          Ostomy Adverse Effects
          Inflammatory Bowel Diseases Complications
          Prednisone Therapeutic Use
          Adalimumab Therapeutic Use
          Drug Combinations Therapeutic Use
          Adult
          Necrosis Prevention and Control
          Ulcer Therapy
          Aged, 80 and Over
          Female
          Japan
          Ostomy Care
          Crohn Disease Complications
          Wound, Ostomy and Continence Nursing
          Adult: 19-44 years
          Aged, 80 & over
          Female
      ab: BACKGROUND: Peristomal pyoderma gangrenosum (PPG) presents multiple challenges for healthcare providers. The diagnosis of PPG may be delayed, and it may be mistaken for an irritant dermatitis or an infection. Patients with ostomies secondary to inflammatory bowel disease (IBD) may experience PPG. Issues related to PPG include difficulty maintaining a seal of the ostomy pouching system and preventing contamination of the painful, necrotic ulcerations characteristic of this condition. Treatment focuses on the appropriate assessment of the ulcers, successful pouch application, and proper management of IBD through a collaborative effort of both dermatologists and certified WOC nurses (CWOCN). CASES: We treated 3 patients diagnosed with Crohn's disease (CD) who developed refractory PPG. All 3 were treated with a topical steroid lotion, prednisone, and adalimumab or a combination of these agents. Ostomy products and application were tailored to prevent leakage and protect areas of ulceration. All ulcers were healed within 6 months of our initial consultation. CONCLUSION: We successfully managed 3 patients with CD and PPG with appropriate ostomy care, including revision of the ostomy pouching techniques, topical steroid treatment, and treatment based on assessment of ulcer status by the dermatologist and the WOC nurse.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        Journal Article
      ougenre: Article
    language: English
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