Department of Dermatology, George Washington University School of Medicine, Washington, DC, USA.
Dermatitis. 2010 May-Jun;21(3):138-47.
Peristomal dermatoses commonly afflict the area around stoma openings in ostomy patients. These complications, however, are often unreported by patients and remain untreated for years, thus affecting maintenance and recovery from the surgery. These dermatoses can have chemical, mechanical, irritant, bacterial, immunologic, or disease-related etiologies. Examples of common forms of dermatitis that occur peristomally include fecal or urine irritant contact dermatitis, chronic papillomatous dermatitis, mechanical dermatitis, and allergic contact dermatitis. This article summarizes various skin irritations that can occur after an ostomy and also reviews previously published reports of peristomal allergic contact dermatitis. In addition, the clinical importance of identifying these dermatoses (most important, their effects on the patient's quality of life), risk factors for the skin irritations, the importance of patch testing, treatment of stoma dermatitis, and the importance of patient education and patient-doctor communication are also discussed.
造口周围皮肤病在造口患者的造口周围区域很常见。然而,这些并发症通常不会被患者报告,并且多年来未得到治疗,从而影响手术的维持和康复。这些皮肤病可能有化学、机械、刺激、细菌、免疫或与疾病相关的病因。常见的造口周围皮炎形式包括粪便或尿液刺激接触性皮炎、慢性乳头状皮炎、机械性皮炎和过敏性接触性皮炎。本文总结了造口后可能发生的各种皮肤刺激,并回顾了先前发表的造口周围过敏性接触性皮炎的报告。此外,还讨论了识别这些皮肤病的临床重要性(最重要的是,它们对患者生活质量的影响)、皮肤刺激的危险因素、斑贴试验的重要性、造口皮炎的治疗以及患者教育和医患沟通的重要性。