Cutaneous Complications of Stomas and Fistulae

Abstract

An abdominal stoma (ostomy) is a surgically created opening from the gastrointestinal or urinary tract onto the skin in order to drain the effluent from that system. This typically involves a collection device worn on the skin, usually held in place by an adhesive material. In theory most dermatoses could affect peristomal skin. In practice the majority fall into one or more of a few predictable groups: irritant reactions including dermatoses exacerbated by trauma, allergic reactions, infections, common generalised inflammatory dermatoses (e.g. psoriasis) and disorders associated with the reason for surgery especially Crohn disease. Treatment strategies involve the avoidance of irritants or allergens where relevant. Topical therapies need to be chosen carefully to minimise greasiness that would interfere with appliance adhesion. For the same reason progression to systemic therapy may be considered earlier for more severe inflammatory dermatoses such as psoriasis or pemphigoid.