The relevance of patch testing in peristomal dermatitis.

BACKGROUND

Skin disorders are a common problem for ostomates, resulting in more than a third of visits to a stoma nurse. Irritant reactions, particularly irritant contact dermatitis, are the most frequently seen, accounting for > 50% of problems in some studies.

OBJECTIVES

To report our experience in patch testing for peristomal dermatitis.

METHODS

All patients were identified from our database of the skin-stoma clinic. Patch testing to various chemicals was performed and results analysed.

RESULTS

From a total of 850 stoma patients in the combined clinic, 149 patients were patch tested. Only seven patients (4·7%) had positive reactions of current, proven relevance, none of which was related to constituents of the stoma appliances themselves. Most of the relevant allergens were preservatives and fragrances.

CONCLUSIONS

The symptoms and clinical appearances of allergic contact dermatitis and irritant contact dermatitis are similar in the occluded peristomal environment and are therefore difficult to distinguish on clinical grounds alone. Allergy is a relatively infrequent cause of peristomal dermatitis despite the continual exposure of skin to the components of cleansers, medicaments, other accessories and the stoma bag systems themselves.