Refractory parastomal ulcers: A multidisciplinary approach

H. C. Wolfsen, L. L. Brubacher, C. S. Ng, A. L. Kayne, R. A. Kozarek

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Chronic parastomal ulcers in patients with ileostomy or colostomy stomas are unusual. Previous reports have implicated infections, fistulas, recurrent inflammatory bowel disease (IBD), pyoderma gangrenosum, and trauma. Over the past 8 years we have evaluated 10 cases of such refractory parastomal ulcers that occurred at a mean of 11 years after stomal surgery. Eight patients had had an ileostomy for IBD while two had undergone colostomy for colon cancer. Five patients with IBD were diagnosed as having pyoderma gangrenosum ulcerations. They required systemic treatment for a mean of 25 weeks to effect ulcer healing. The other five patients had either parastomal ulcers on the basis of dermatoses (contact dermatitis, eczema, or bullous pemphigoid) or contact ulcers due to face-plate pressure and parastomal dermatitis. These patients received topical treatment with healing of ulcers in a mean of 4 weeks. We conclude that parastomal ulcers occurring in patients without IBD or IBD patients without classic pyoderma gangrenosum require early dermatologic evaluation as they respond relatively quickly to appropriate local therapy.

Original languageEnglish (US)
Pages (from-to)651-655
Number of pages5
JournalJournal of clinical gastroenterology
Volume12
Issue number6
DOIs
StatePublished - Dec 1990

Keywords

  • Ileostomy
  • Ileostomy complication
  • Parastomal ulcer

ASJC Scopus subject areas

  • Gastroenterology

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    Wolfsen, H. C., Brubacher, L. L., Ng, C. S., Kayne, A. L., & Kozarek, R. A. (1990). Refractory parastomal ulcers: A multidisciplinary approach. Journal of clinical gastroenterology, 12(6), 651-655. https://doi.org/10.1097/00004836-199012000-00011