Abstract
Pyoderma gangrenosum (PG) is a refractory extraluminal disease that can be complicated by ulcerative colitis. Patients with PG may sometimes have to undergo total proctocolectomy. Although there have been many reports that have suggested that PG can be resolved by total proctocolectomy, hear, we describe 3 cases in which PG developed after total proctocolectomy.
Case 1 : A 37-year-old woman developed PG in the right ankle, 4 years after undergoing total proctocolectomy. Although initially, she showed improvement often steroid administration, the condition aggravated when the dose was decreased. Her symptoms improved often cytapheresis (CAP) and administration of an immunosuppressant.
Case 2 : A 32-year-old woman developed PG in the right leg 5 months after total proctocolectomy. Her symptoms improved often CAP.
Case 3 : A 39-year-old woman with aggravated ulcerative colitis was observed to have renal-cell carcinoma during a detailed examination. PG developed in the left leg 1.5 months after total proctocolectomy and removal of the right kidney. At present, her symptoms have improved with the administration of a steroid and an immunosupperessant and CAP. In all the cases, no relapse of residual rectal mucosa and ileal pouchitis were observed.
Conclusion : In addition to preoperative follow-up, short-and long-term postoperative follow-ups for PG are essential in cases of ulcerative colitis.
