Scholarlink

This is a parastomal ulcer (Fig. 103.1), lying below an end ileostomy. It is not a “peristomal ulcer” as “peri” means around, while “para” means beside. Features of the condition displayed by this patient include an irregular border, undermined in many areas, with a base of granulation tissue. The main differential diagnosis is parastomal pyoderma gangrenosum (PPG), but in this case, there is no evidence of ischemia or vasculitis. (Ischemia is manifest as a black/gray, or greenish or yellowish tinge to the base of the ulcer. Once the ulcer becomes chronic, granulations cover the base.) It is often hard to differentiate a parastomal ulcer from PPG, especially when the ulcer is chronic, but the evolution of the condition can be a clue. Nonspecific parastomal ulcers generally heal with appropriate management. If they don’t heal, it makes PPG more likely.

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

What Condition Is Depicted in This Photograph? What Do You Call It, How Does It Happen, and How Do You Manage It?

  • 章节

  • 发表日期：

    2025年

查看全文
  • James M. Church

摘要

This is a parastomal ulcer (Fig. 103.1), lying below an end ileostomy. It is not a “peristomal ulcer” as “peri” means around, while “para” means beside. Features of the condition displayed by this patient include an irregular border, undermined in many areas, with a base of granulation tissue. The main differential diagnosis is parastomal pyoderma gangrenosum (PPG), but in this case, there is no evidence of ischemia or vasculitis. (Ischemia is manifest as a black/gray, or greenish or yellowish tinge to the base of the ulcer. Once the ulcer becomes chronic, granulations cover the base.) It is often hard to differentiate a parastomal ulcer from PPG, especially when the ulcer is chronic, but the evolution of the condition can be a clue. Nonspecific parastomal ulcers generally heal with appropriate management. If they don’t heal, it makes PPG more likely.