Pioderma gangrenoso periestomal: presentación de 4 casos y revisión de los factores de riesgo y la respuesta terapéutica / A Case Series of 4 Patients With Peristomal Pyoderma Gangrenosum: Review of Risk Factors and Treatment Response

La literatura del pioderma gangrenoso periestomal (PGP) es escasa, y las series publicadas tienen un número de pacientes limitado. En dicho contexto es difícil determinar la frecuencia de la enfermedad, así como sus factores de riesgo, y valorar la eficacia de los distintos tratamientos disponibles. Presentamos una serie de casos de PGP diagnosticados en nuestro centro entre los años 2013 y 2014 y revisamos las características clínicas y la respuesta terapéutica. Se incluyeron un total de 4 pacientes, 3 de los cuales estaban diagnosticados de enfermedad inflamatoria intestinal, mientras que uno de los casos se asoció a carcinoma de recto. Tres pacientes presentaron evolución favorable tras el tratamiento inicial con tacrolimus 0,1% en pomada (2 casos en monoterapia y uno asociado a otros inmunosupresores), con recurrencia en todos ellos tras la suspensión del tratamiento precisando reintroducción o cambio de tratamiento

The literature on peristomal pyoderma gangrenosum (PPD) is scarce, and studies to date have included few patients. It is therefore difficult to determine the incidence of PPD, investigate risk factors, or evaluate the effectiveness of the different treatments available. We report on a series of 4 patients diagnosed with PPD at our hospital in 2013 and 2014, and review the clinical characteristics and responses to treatment. Three of the patients had inflammatory bowel disease and 1 had rectal cancer. Three patients responded favorably to initial treatment with 0.1% tacrolimus ointment (administered as monotherapy in 2 cases and combined with immunosuppressants in the other). However, on withdrawal of tacrolimus, the disease recurred in all 3 patients, requiring treatment reintroduction or modification

A Case Series of 4 Patients With Peristomal Pyoderma Gangrenosum: Review of Risk Factors and Treatment Response.

The literature on peristomal pyoderma gangrenosum (PPD) is scarce, and studies to date have included few patients. It is therefore difficult to determine the incidence of PPD, investigate risk factors, or evaluate the effectiveness of the different treatments available. We report on a series of 4 patients diagnosed with PPD at our hospital in 2013 and 2014, and review the clinical characteristics and responses to treatment. Three of the patients had inflammatory bowel disease and 1 had rectal cancer. Three patients responded favorably to initial treatment with 0.1% tacrolimus ointment (administered as monotherapy in 2 cases and combined with immunosuppressants in the other). However, on withdrawal of tacrolimus, the disease recurred in all 3 patients, requiring treatment reintroduction or modification.

Localized acneiform eruption following radiotherapy in a patient with breast carcinoma.

The vast majority of patients treated with radiotherapy develop dermatological side effects. Acute radiation dermatitis or chronic skin fibrosis are well known sequels of radiation, but there are also other infrequent skin toxicities following external radiotherapy we should be aware of. We present a case of a rare form of delayed radiation dermatitis consisting of a localized acneiform eruption, confirmed by skin biopsy, in the irradiated fields in a woman with breast cancer. We review the clinical characteristics and risk factors available in the literature about this unusual adverse effect of radiotherapy. It is important for dermatologists to recognize this rare adverse effect, owing to the important impact on physical and psychosocial health of the patients and because it may delay the surgical reconstruction.