A 77-year-old female patient, who had been previously diagnosed with granulomatous colitis and had a colostomy, was admitted for an acute episode. She presented painful, irregular, and deep ulcers on the peristomal circumference that led to its disengagement. The pathology report of a skin punch biopsy identified neutrophil infiltration to the hypodermis, focal abscesses, microgranulomas and necrosis compatible with pyoderma gangrenosum. Treatment was started with IV corticosteroids, topical metronidazole, local treatment with Aquacel® and hydrocolloid dressings. Due to progressive worsening of the ulcers (Fig. 1), we decided to escalate treatment to infiltration with corticosteroids and 0.1% tacrolimus ointment. Given the persistence of the condition, treatment with infliximab was started, and the condition gradually improved until the skin was intact, observing no problems with the devices (Fig. 2).
Please cite this article as: Garcia Dominguez A, Saralegui Ansorena Y, Artola Etxeberria M, Enríquez-Navascués JM. Pioderma gangrenoso periestomal en paciente con enfermedad inflamatoria intestinal. Cir Esp. 2021;99:464.
