A Case of Periostomal Pyoderma Gangrenosum after Surgery for Rectal Cancer

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  • Tsunemi S.
    Department of Gastroenterological and General Surgery, Saiseikai Suita Hospital
  • Izumi N.
    Department of Gastroenterological and General Surgery, Saiseikai Suita Hospital
  • Iwamoto S.
    Department of Gastroenterological and General Surgery, Saiseikai Suita Hospital
  • Hara A.
    Department of Gastroenterological and General Surgery, Saiseikai Suita Hospital
  • Kitagawa K.
    Department of Dermatology, Saiseikai Suita Hospital

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  • 直腸癌術後，人工肛門周囲に発症した壊疽性膿皮症の１例

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Abstract

A 72-year-old woman underwent abdomino-perineal excision of the rectum for rectal cancer. Postoperatively, an undermining ulcer around the colostomy with severe pain developed and showed rapid dilatation. We diagnosed the lesion as peristomal pyoderma gangrenosum (PPG) based on the clinical course, macroscopic findings and biopsy, and topical treatment with a tacrolimus salve was administered. With this therapy, the ulcer improved. PPG can occur at the stoma circumference similar to that in patients with ulcerative colitis or Crohn's disease, and it is an intractable ulcer. PPG is a rare disease, and almost all previous patients with PPG have had autoimmune disease. There is no previous report in Japan of PPG emerging postoperatively in a patient with rectal cancer without a medical history of autoimmune disease. We think the clinical condition is an important complication that must be considered after construction of a stoma.<br>

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