Pyoderma gangrenosum occurring at the peri-ileal pouch-anal anastomosis in a patient with ulcerative colitis: report of a case.

Pyoderma gangrenosum (PG) is an idiopathic, inflammatory, ulcerative skin disorder; the etiology and pathogenesis of which are still poorly understood. It is one of the most important extraintestinal manifestations that can appear in the course of ulcerative colitis (UC). Although skin ulcers with destructive and necrotizing components are more commonly observed on the lower extremities and trunk, PG at stomal sites (peri-stomal PG) has been increasingly reported in patients with inflammatory bowel diseases (IBDs), including UC. Although PG at various surgical sites has been reported as an unusual presentation of PG, postoperative PG developing at the ileal pouch-anal anastomosis (IPAA) has not been reported previously. We herein report the first published case of a patient with UC who developed peri-anastomotic PG after IPAA during the postoperative tapering of systemic corticosteroids.