A Case Of Peristomal Pyoderma Gangrenosum Following Enterocutaneous Fistula

Pyoderma gangrenosum (PG) is an uncommon ulcerative skin disorder that is often associated with underlying systemic diseases, the most common of which is inflammatory bowel disease. It can rarely develop after minor trauma or surgery. Most reports of this condition developing after abdominal surgery have been reported following ostomy formation. Peristomal pyoderma gangrenosum (PPG), an unusual variant of PG, has been reported almost exclusively in patients with inflammatory bowel disease and is frequently misdiagnosed. We describe a 62-year-old woman with refractory PG, which has developed at surgical site of enterocutaneous fistula operation. As PG can mimic a necrotizing soft tissue infection, multiple unnecessary surgical procedures can be performed on such a patient, without improvement. A right diagnosis, based upon the distinctive clinical features and a compatible histology, is essential to avoid surgical procedure that often tends to exacerbate this unusual process.