The relevance of patch testing in peristomal dermatitis

Al‐Niaimi, Firas; Beck, M. H.; Almaani, Noor; Samarasinghe, Venura; Williams, Jason D.; Lyon, C. C.

doi:10.1111/j.1365-2133.2012.10925.x

Cited by 18 publications

(24 citation statements)

References 25 publications

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“…Previous reports estimated a prevalence of both allergic and irritant peristomal contact dermatitis caused by an external agent of 0.5–4.7% . Our series was heavily biased by our referral population of patients with recalcitrant peristomal dermatitis and several reactions that were probably IRs; hence, relative frequencies cannot be compared.…”

Section: Discussionmentioning

confidence: 96%

“…It would be interesting to test as much as possible with the specific causative agents in appropriate concentrations and vehicles, respectively, to distinguish between allergy and irritancy. The published literature suggests that the most common allergens causing ACD in ostomates are epoxy resins (no longer used), Gantrez ® copolymers (ChemPoint, Bellevue, WA, USA), D-limonene, and (un)known allergens in various stoma skin care products (ostomy pouching systems, skin barriers, and adhesive removers) (8,9,(23)(24)(25)(26)(27)(28). Gantrez ® is a polymethylvinyl ether maleic anhydride copolymer (two formulations: Gantrez ® -425 and Gantrez ® -335) that is used in various personal care products, and as an adhesive component in a range of stoma pastes.…”

Section: Discussionmentioning

confidence: 99%

“…Product testing was performed either as a use test or a patch test. In most patients (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), the use test was employed, as the product being tested is normally either applied and then occluded under adhesive dressings or is the adhesive dressing itself. For the use test, we identified an area of uninvolved skin of ∼10 cm 2 on which to apply the product.…”

Section: Methodsmentioning

confidence: 99%

“…The role of these products as irritants is also poorly understood. Most of the evidence in the literature is in the form of case reports and case series, and there are no large-scale studies reporting on these events (8,10). Herein, we evaluate irritant and allergic aetiologies for peristomal dermatitis, and identify commonly used products as culprits.…”

mentioning

confidence: 99%

“…fragrances and colophonium), we reasoned that stoma skin care products may represent a previously unappreciated cause of peristomal dermatitis. Allergic contact dermatitis (ACD) has been infrequently reported (0.5-4.7%) (5)(6)(7)(8), but, when it is present, it is often caused by stoma skin care products (9). The role of these products as irritants is also poorly understood.…”

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confidence: 99%

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Stoma care products represent a common and previously underreported source of peristomal contact dermatitis

et al. 2016

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BACKGROUND Peristomal dermatitis is a common complication for the 700000+ patients in the US with an ostomy. The role of stoma skin care products (SSCP) in peristomal dermatitis is poorly understood. OBJECTIVE To evaluate SSCPs as a cause of peristomal dermatitis. METHODS Retrospective chart review of patients with peristomal dermatitis at 4 academic hospitals from Jan 2010 to March 2014. Patient demographics, clinical information, and use test and patch test results were documented. RESULTS 18 patients identified with peristomal dermatitis were tested. The frequency of peristomal contact dermatitis was 12/18. We identified numerous stoma skin care products as triggers of irritant and/or allergic contact dermatitis. The most common stoma skin care product used and/or involved in dermatitis was Cavilon™ No Sting Barrier Film. CONCLUSIONS Our data support a paradigm shift where health care workers treating patients with peristomal dermatitis, currently considered a reaction mainly to bodily fluids, must now consider those products used to protect the skin as potential triggers for this disease. Therefore, patients with peristomal dermatitis should be tested to their stoma skin care agents to determine the need for removing or changing these products. Additionally, full ingredient labeling by manufacturers would help identify new allergens and irritants.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Stoma care products represent a common and previously underreported source of peristomal contact dermatitis

et al. 2016

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Cutaneous Complications of Stomas and Fistulae

Lyon

2016

Rook's Textbook of Dermatology, Ninth Edition

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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 generalized inflammatory dermatoses (e.g. pemphigoid) 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 minimize 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.

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Cutaneous Complications of Stomas and Fistulae

Lyon

2024

Rook's Textbook of Dermatology

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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.

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The relevance of patch testing in peristomal dermatitis

Cited by 18 publications

References 25 publications

Stoma care products represent a common and previously underreported source of peristomal contact dermatitis

Stoma care products represent a common and previously underreported source of peristomal contact dermatitis

Cutaneous Complications of Stomas and Fistulae

Cutaneous Complications of Stomas and Fistulae

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