The spectrum of skin disorders in abdominal stoma patients

Abstract

Background Skin integrity is essential for the normal usage of a stoma appliance. However, there is little published on the prevalence, nature or management of stoma‐related skin disorders. Objectives To document stoma‐related skin disorders in a large cohort of patients. Methods We sent a postal questionnaire to all surviving patients who had had abdominal stoma surgery at Hope Hospital, Salford, U.K. in the 10 years from 1 January 1989. Those reporting skin disease were invited to attend a clinic run by a dermatologist and a stoma‐care specialist nurse. All lesions were categorized and swabs taken for microbiological examination. Results Of 525 surviving patients, 325 (62%) replied to the questionnaire. Of these, 73% reported a skin problem that had affected normal stoma bag use. Dermatoses included irritant reactions, particularly from leakage of urine or faeces (42%); pre‐existing skin diseases, principally psoriasis, seborrhoeic dermatitis and eczema (20%); infections (6%); allergic contact dermatitis (0·7%) and pyoderma gangrenosum (0·6% annual incidence). A further 15% of patients with skin problems had persistent or recurrent dermatitis not explained by allergy, frank infection or faecal irritation. This responded to short‐term treatment with topical corticosteroids. Further investigation is under way into its pathogenesis. Conclusions Skin disorders are common in stoma patients, and various patterns can be recognized and effectively treated.