Chronic Papillomatous Dermatitis as a Peristomal Complication in Conduit Urinary Diversion

Abstract

In 76 patients with conduit urinary diversion, the skin in the stomal area was studied with regard to complications. No such complications had occurred in 39 cases. Superficial erosive dermatitis was present or had been a transient episode in 27 cases. The immediate peristomal area was found in ten cases to show a different type of complication. This was characterized by hyperplastic, papillomatous skin lesions of a chronic nature. A rubber urinary collecting device for long-term use had been fitted in nine of the ten patients, and none of them had a protruding nipple stoma. The clinical, microbiologic and histologic features of these hyperplastic lesions are described and aetiologic factors are discussed. Change to another type of collecting device was followed within three to six weeks by healing of the lesions.

Vulvar Pseudoverrucous Papules and Nodules Secondary to a Urethral–Vaginal Fistula

“…Several pathogenic mechanisms seem to be involved. [3][4][5][6]11 The clinical differential diagnosis includes bacterial infections, viral warts, syphilitic condylomas, cutaneous Crohn disease, halogenodermas, necrolytic migratory erythema, and deficiency disorder (pellagra). 3,9 The process is favored in some cases by diaper coverings.…”

“…1,2 Diaper dermatitis includes a spectrum of inflammatory reactions that usually represent an irritant contact dermatitis to feces, urine, or both, which is characterized by a diffuse erythematous rash with occasional micropapules and scaling areas. [3][4][5][6][7] Contact dermatitis of the vulva can also be a confounding factor in patients with symptoms of vulvar pruritus, irritation, or burning. [3][4][5][6][7] Contact dermatitis of the vulva can also be a confounding factor in patients with symptoms of vulvar pruritus, irritation, or burning.…”

Erosive papulonodular dermatosis associated with topical benzocaine: A report of two cases and evidence that granuloma gluteale, pseudoverrucous papules, and Jacquet's erosive dermatitis are a disease spectrum

“…Lesions similar to PPPN were first reported in association with irritation from urostomies. 10,11 In one case series, one fifth of patients with urostomies displayed pseudoverrucous skin lesions in a peristomal location. These lesions were described as wartlike papules, or small, white-gray or reddish-tobrown erosive papules about 2 to 3 mm in size.…”

“…Biopsy specimen of these pseudoverrucous skin lesions demonstrated epidermal acanthosis, similar to that seen in PPPN. 11 ''Jacquet's erosive diaper dermatitis'' is a term that has been occasionally used to describe welldemarcated ulcers and erosions on the labia or penis. 13,25,26 These lesions typically have elevated borders and may be umbilicated.…”

“…1,10 It may also occur in the perianal area secondary to urinary incontinence or encopresis, and is also believed to be an irritant dermatitis. 1,2,10,11 Lesions are described as ''shiny, smooth, red, moist, flat-topped and round.'' 1 There is considerable overlap in the clinical appearance of both of these conditions, yet previous reports have stressed that granuloma gluteale and PPPN are separate and distinct entities based on differences in the histopathology of the lesions.…”