title: Healing of a pyoderma gangrenosum at the site of a percutaneous endoscopically sited gastrostomy tube without tube removal.
abstract: Pyoderma gangrenosum (PG) is a rare but important cause of pain and morbidity, and is associated with malignancy and shows pathergy. Occurrence at a percutaneous endoscopic gastrostomy (PEG) site is rare and may prompt PEG tube removal. This case describes management of PG at a PEG site in a man with squamous cell carcinoma of the orophayrnx. Successful healing of the lesion was achieved despite the PEG tube remaining in situ. Care was delivered within the hospice setting with support from the local dermatology service. Infection of the wound was treated with a recently licensed antimicrobial with a novel action. This allowed nutrition to continue, promoting healing further and ensuring a route of delivery for medications, avoiding intravenous therapy.
authors.affiliation: St Mary's Hospice, Birmingham, UK.
authors.forename: Charles
authors.initials: C
authors.lastname: Davis
authors.affiliation: St Mary's Hospice, Birmingham, UK.
authors.forename: Bethany
authors.initials: B
authors.lastname: Wright
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000628:therapy; D020878:Device Removal; D004724:Endoscopy; D004750:Enteral Nutrition / Q000009:adverse effects*; D005774:Gastrostomy; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000150:complications / Q000628:therapy; D011183:Postoperative Complications; D017511:Pyoderma Gangrenosum / Q000209:etiology / Q000628:therapy*; D012867:Skin / Q000473:pathology*; D014945:Wound Healing; D014946:Wound Infection / Q000188:drug therapy
chemical_list: D000890:Anti-Infective Agents