Ostomy 101 for dermatologists: Managing peristomal skin diseases

An estimated 1 million North Americans live with ostomies, with up to 80% of ostomy patients developing stoma-related skin morbidities. While ostomy nurses are often the first line of management, dermatologists may be involved in the care of ostomy patients with complex or persistent peristomal skin complications. Therefore, an understanding of the ostomy apparatus and possible peristomal skin conditions that may arise allows dermatologists to identify skin complications early and work effectively with a multidisciplinary team. In this article, we aim to review the ostomy apparatus, discuss the differential diagnoses, and provide practical guidelines for the management of peristomal skin conditions. Pubmed, Ovid Medline, and Google Scholar were searched for relevant articles assessing peristomal skin complications and their management. Peristomal skin complications may be local (e.g., contact dermatitis, infection, fistula, and mechanical trauma) or secondary to systemic disease (e.g., inflammatory bowel disease, pyoderma gangrenosum, and psoriasis). Ensuring appropriate ostomy fit and proper use of ostomy accessory products helps to reduce effluent leakage and prevent damage to the peristomal skin. For persistent peristomal skin conditions, corticosteroid sprays, systemic therapies, and surgical interventions may be warranted.