Early diagnosis and early corticosteroid administration improves healing of peristomal pyoderma gangrenosum in inflammatory bowel disease

Yuji Funayama, Eiko Kumagai, Ken Ichi Takahashi, Kohei Fukushima, Iwao Sasaki

Research output: Contribution to journalArticlepeer-review

23 Citations (Scopus)

Abstract

PURPOSE: To evaluate the efficacy of early diagnosis and early administration of corticosteroid for peristomal pyoderma gangrenosum, a prospective study was carried out. METHODS: In April 1998, we began studying a new treatment regimen of peristomal pyoderma gangrenosum in which prednisone at a dose of 20 to 40 mg was administered systemically immediately after diagnosis. Early-stage peristomal pyoderma gangrenosum was treated concurrently with topical cadexomer iodine, and at the granulation stage, treatment with clobetasol ointment was started. Healing of peristomal pyoderma gangrenosum was determined by complete epithelialization of ulcer without pain or exudates. Patients were assigned to group A (n = 7) before April 1998 and group B (n = 10) after April 1998, and historical comparison was done between the 2 groups. RESULTS: In group A, all patients had ulcerative colitis, and in group B, 7 patients had ulcerative colitis, 2 had Crohn's disease, and one had indeterminate colitis. In group B, significantly earlier diagnosis (P = 0.0093), earlier start of treatment (P = 0.0057), higher initial dose of corticosteroid (P = 0.0052), and earlier healing of peristomal pyoderma gangrenosum (P = 0.0023) were observed. CONCLUSIONS: Early diagnosis and early corticosteroid administration appeared to be effective for promoting healing of peristomal pyoderma gangrenosum.

Original languageEnglish
Pages (from-to)311-314
Number of pages4
JournalDiseases of the Colon and Rectum
Volume52
Issue number2
DOIs
Publication statusPublished - 2009 Feb 1

Keywords

  • Enterostomy
  • Extraintestinal manifestation
  • Inflammatory bowel disease
  • Pyoderma gangrenosum

ASJC Scopus subject areas

  • Gastroenterology

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