Features, Treatments, and Therapeutic Outcomes of Peristomal versus Non-Peristomal Pyoderma Gangrenosum in 45 Patients with Inflammatory Bowel Disease: A Single-Institution Study, 2002 through 2021.

Abstract

Pyoderma gangrenosum (PG) is the second most common skin manifestation reported in patients with inflammatory bowel disease (IBD). We performed a single-institution, retrospective study to summarize the clinical features and examine effective treatment regimens and outcomes of PG in IBD patients. We identified 45 patients who presented to our institute between January 1, 2002 and December 31, 2021 with the following criteria: (1) diagnosed with an active PG (ICD9: 686.01, ICD10: L88) during the specified period, (2) aged at least 18 years at the time of diagnosis, (3) had the diagnosis of IBD, and (4) documented treatment regimens/outcomes. In our cohort, 56% of the patients had PG at the site of stoma. Intralesional and oral steroids were the most utilized therapies for peristomal PG (PPG) and non-peristomal PG (NPPG) in 60% and 62% of the patients, respectively. The bowel manifestations were under control at the time of PG diagnosis in 76% of PPG patients, compared to 43% of NPPG patients. Our findings demonstrated that PPG in IBD patients could be managed locally with intralesional steroids only, as the bowel manifestations of PPG patients tend to be under control, compared to those of NPPG patients.