• Cheryl Chong, Prasad Palanisamy, and Eugene Shen-Ann Yeo.
• Department of General Surgery, Sengkang General Hospital, Singapore cheryl.chong.x.z@skh.com.sg.
• BMJ Case Rep. 2021 May 7; 14 (5).

AbstractPeristomal pyoderma gangrenosum (PPG) is a rare clinical entity, which can masquerade as the more common and lethal necrotising fasciitis. The authors present a case of PPG in a 65-year-old woman who underwent robotic abdominoperineal resection for low rectal carcinoma and returned 8 days postoperation for peristomal skin ulcerations and pain, accompanied by leucocytosis; thus, she was treated as per necrotising fasciitis and underwent surgical debridement. Thereafter, her wound continued to worsen despite conventional wound care with vacuum-assisted closure and demonstrated signs of pathergy. The case was referred to dermatology where a diagnosis of PPG was made. This case report presents a cautionary tale for fellow clinicians, highlights the diagnostic challenge, and presents an updated literature review on diagnosis and management of this unique condition.© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.

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