A Case of Peristomal Pyoderma Gangrenosum 11 Years after Restorative Proctocolectomy for Ulcerative Colitis

Abstract

A 46-year-old man was diagnosed as having ulcerative colitis in 1989. Because his medical treatment was not effective, total colectomy with Heal pouch anal anastomosis was performed. Four months later, ileostomy was performed because of late fistula at the anastomotic site, and it had not been closed as he did not want an operation. A giant ulcer emerged on the peristomal skin in June 2001, and was diagnosed as peristomal pyoderma gangrenosum (PPG). Predonisolone and cyclosporin were administered but were not effective, but clofazimine was effective and signs of his ulcer diminished by using clofazimine. After this therapy, he had local treatment with ointment containing steroid only. PPG complicating ulcerative colitis can arise even long after a total proctocolectomy. PPG as a significant complication of ulcerative colitis with stoma should be considered.