A Case of Peristomal Pyoderma Gangrenosum treated with Takurorimus Ointment

Kazuhiko Yanagisawa, Masayoshi Yamamoto, Shinji Yazawa*, Yumiko Takeda*, Yoshimasa Akashi and Nobuhiro Ohkouchi

Department of Surgery, Institute of Clinical Medicine, University of Tsukuba
Department of Nursing, University Hospital of Tsukuba*

We report a case of peristomal pyoderma gangrenosum treated by topical application of an immunosuppressive drug. The patient was a 25-year-old man in whom sigmoid colostomy had been undertaken for intractable anal fistula. He remained in a good condition with medical therapy, but suddenly presented with rapidly growing skin ulcerations, which were severely painful, appearing acutely at the periphery of the stoma. We diagnosed the condition as pyoderma gangrenosum, and initiated treatment with systemic steroids and topical tacrolimus ointment, and the skin ulcerations healed immediately. Pyoderma gangrenosum, especially in the peristomal region is difficult to treat. Topical tacrolimus ointment is often used for the treatment of pyoderma gangrenosum in the United States and Europe, but its use has been few reported from Japan. We report the present case in detail and discuss it with a review of the literature.

Key words
Crohn diease, peristomal pyoderma gangrenosum, tacrolimus ointment

Reprint requests
Kazuhiko Yanagisawa Department of Surgery, Institute of Clinical Medicine, University of Tsukuba
2-1-1 Amakubo, Tsukuba, 305-8575 JAPAN

Accepted
September 17, 2008

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