Resolved Peristomal Erosive Papulonodular Dermatitis Mimicking Nevoid Hyperkeratosis of the Nipple and Areola

Nevoid hyperkeratosis of the nipple and areola (NHKNA) is a rare cutaneous entity with a distinct clinical and histological presentation. The type II form of this condition can result from various dermatoses, such as irritant contact dermatitis. Erosive papulonodular dermatitis is a chronic irritant dermatitis that often occurs in areas of occlusion and maceration, such as peristomal skin. Pseudoverrucous papules and nodules are a variant of erosive papulonodular dermatitis and have a non-specific histologic pattern of reactive hyperplasia.

We present a case of a patient with resolved peristomal erosive papulonodular dermatitis who presented status-post ileostomy reversal with clinical and histologic findings classically seen in NHKNA.

In type II NHKNA, treatment of the primary dermatosis typically leads to resolutions. In the case of our patient, removal of the offending agent via colostomy reversal and barrier protection led to the resolution of the lesions.