A case of peristomal pyoderma gangrenosum induced by post extirpation of bladder carcinoma followed by ileal conduit formation: Analysis of 107 cases

A 57-year-old man underwent total resection of bladder carcinoma, followed by ileal conduit formation on 1998. Six years later, a pustule appeared on the right side of the stoma, enlarged rapidly and became a pyodermic ulcer. Skin biopsy from the lesion revealed a massive inflammatory infiltrate mainly composed of neutrophils. No abnormalities were found in routine hematological or gastric intestinal examinations. Based on clinical and histological findings, we made the diagnosis of peristomal pyoderma gangrenosum (PPG). Topical application of diflucortolone valerate resulted in prompt improvement. Of 107 patients with PPG, 82 patients had inflammatory bowel disease, with 49 of these patients having Crohn's disease and 33 having ulcerative colitis. Other underlyng diseases included diverticulitis (8 cases), colon carcinoma (5 cases), bladder carcinoma (4 cases), neurological bladder (2 cases), colitis (2 cases), bowel perforation (1 case), volvulus (1 case), bowel abscess (1 case), and urethral valves (1 case).