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Perioperative management and clinical outcomes of peristomal pyoderma gangrenosum

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Abstract

Peristomal pyoderma gangrenosum is an uncommon subtype of pyoderma gangrenosum mainly affecting stoma sites of patients with inflammatory bowel disease. While surgical treatments are often used to assist healing, little is known about the relationship between surgical interventions and the rate of recurrence of peristomal pyoderma gangrenosum. The aim of this study was to identify patient and clinical factors associated with peristomal pyoderma gangrenosum recurrence following surgical intervention. A multi-institutional retrospective case series and literature review was conducted to evaluate patient characteristics and perioperative treatment. Patients of any age with peristomal pyoderma gangrenosum undergoing surgical operations related to their pyoderma gangrenosum or due to another comorbidity were included. Descriptive statistics were used to characterize demographic information. Associations were evaluated using Wilcoxon’s rank-sum test for continuous variables and Fisher’s exact test for categorical data. Thirty-seven cases were included, 78.3% of which had a history of inflammatory bowel disease. Overall, 13 (35.1%) cases experienced recurrence at 30 days. There was no significant association identified between patient demographics, stoma location, surgical intervention, or perioperative treatment with rate of recurrence at 30 days post-operation. While no clinical risk factors or treatments were associated with recurrence, our work underscores the importance of a multidisciplinary approach to this disease to address gastrointestinal, dermatologic, and surgical components of treatment.

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The data underlying this article will be shared on reasonable request to the corresponding author.

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Funding

No funding was provided for this study.

Author information

Authors and Affiliations

  1. Department of Dermatology, Oregon Health and Science University, 3303 S Bond Ave Building 1, 16th Floor, Portland, OR, 97239, USA

    Sarah L. Becker, Georgia Mae Morrison & Alex G. Ortega-Loayza

  2. School of Medicine, Universidad de los Andes, Bogotá D.C., Colombia

    Jorge A. Rios-Duarte

  3. Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Eric **a & Arash Mostaghimi

  4. Boston University School of Medicine, Boston, MA, USA

    Eric **a

  5. Department of Dermatology, The Ohio State University, Columbus, OH, USA

    Sonia Himed & Benjamin H. Kaffenberger

  6. University of Wisconsin, Madison, WI, USA

    Donglin Zhang & Bridget E. Shields

  7. University of Washington, Seattle, WA, USA

    Anna L. Cogen

Authors
  1. Sarah L. Becker
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  2. Jorge A. Rios-Duarte
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  3. Georgia Mae Morrison
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  4. Eric **a
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  5. Arash Mostaghimi
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  6. Sonia Himed
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  7. Benjamin H. Kaffenberger
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  8. Donglin Zhang
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  9. Bridget E. Shields
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  10. Anna L. Cogen
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  11. Alex G. Ortega-Loayza
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Contributions

AGOL and GMM were responsible for study conception and design. Data analysis was performed by JRD, GMM, SLB, AGOL, DZ, and BS. All authors contributed to acquisition of data, drafting of the main text, and final approval of the final manuscript. AGOL provided critical revision during review.

Corresponding author

Correspondence to Sarah L. Becker.

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Conflict of interest

AGOL is the current President of the Pacific Dermatology Association and serves as an associate editor for Dermatology (Karger). In addition, he is a consultant for Genentech and Guidepoint and an advisor to Bristol Meyer Squibb, Boehringer Ingelheim, and Janssen. AGOL has received research grants from Lilly, Janssen, Incyte, and Pfizer. He is supported by NIH NIAMS R01 AR083110. BES serves on the Advisory Board for Arcutis Biotherapeutics and is an author for UpToDate. Her career is supported by the Dermatology Foundation Medical Career Development Award. AM has received consulting fees from Pfizer, hims, Digital Diagnostics, Concert, Lilly, AbbVie, Equillium, Boehringer Ingelheim, and LEO as well as licensing/royalties from Pfizer, Concert, and Lilly; holds equity in and is on the advisory board for hims and Digital Diagnostics; and has participated in clinical trials related to alopecia from Incyte, Lilly, Concert, and Aclaris while serving as an associate editor for JAMA Dermatology.

Ethical approval

IRB approval by Oregon Health and Science University was granted prior to initiation and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Becker, S.L., Rios-Duarte, J.A., Morrison, G.M. et al. Perioperative management and clinical outcomes of peristomal pyoderma gangrenosum. Arch Dermatol Res 316, 98 (2024). https://doi.org/10.1007/s00403-024-02826-3

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  • DOI: https://doi.org/10.1007/s00403-024-02826-3

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