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Chronic papillomatous dermatitis in a patient with a urinary ileal diversion: A case report and review of the literature

Gastrointestinal surgical procedures result in approximately 100,000 ostomies per year in the United States, with over 10,00,000 people living with intestinal stomas [1]. Proper use and management of a stoma appliance relies heavily on peristomal skin integrity; however abdominal stoma patients can develop various dermatologic complications including allergic contact dermatitis, mechanical dermatitis from appliance stripping, infections, pyoderma gangrenosum and irritant contact dermatitis. Peristomal irritant contact dermatitis is partially attributed to leakage around the stoma due to ill-fitting ostomy equipment. Chronic exposure of peristomal skin to urine and fecal matter can manifest as an acanthomatous inflammatory reaction, known as Chronic Papillomatous Dermatitis (CPD). CPD has been classically associated with urostomies, while few ileostomy-associated CPD reports exist [1]. Specifically, it has been attributed to the alkaline pH of urine mechanical irritation and epidermodysplasia verruciformis Human Papilloma Virus (HPV) types [2]. 9.5% of stoma patients reportedly develop CPD after the stoma has been present for an average of 6.5 years [3].