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DOI: 10.1055/a-2360-5099
Peristomal skin lesions – identifying patients at risk
Peristomale Hautveränderungen – Identifikation von Risikopatienten![](https://www.thieme-connect.de/media/zfg/EFirst/lookinside/thumbnails/10-1055-a-2360-5099-1.jpg)
Abstract
Background and Objectives Diagnosis and therapy of peristomal skin lesions are challenging for the majority of therapists. Established diagnostic tools have not yet been validated. Our objective was to outline the spectrum of and to identify risk factors for skin lesions in ostomy patients. A focus was set on peristomal ulcerations and their differentiation as peristomal pyoderma gangrenosum.
Methods In a retrospective analysis, frequency and character of peristomal skin lesions in patients presenting at two departments were analysed. Patients suffering from peristomal ulcerations were subjected to a more detailed analysis including application of the PARACELSUS score.
Results A total of 565 patients with ostomy were analysed; 40.2% (n = 227) presented with peristomal skin lesions. Moisture-associated skin damage (27.9%) was the most common, while ulcerations (21.9%) and eczematous skin alterations (19.1%) were seen with comparable frequency. Peristomal pyoderma gangrenosum was diagnosed in 7.9% of all observed peristomal lesions. Among patients with inflammatory bowel disease (n = 98), peristomal ulcerations were the leading finding (35.7%), and pyoderma gangrenosum was more frequent in these patients (16.3%).
Conclusions It is necessary to assess and classify peristomal skin lesions. Further studies for the validation of different scores or the development of diagnostic tools are needed.
Zusammenfassung
Hintergrund und Zielsetzung Diagnose und Therapie von peristomalen Hautläsionen stellen für die meisten Behandler eine Herausforderung dar. Die etablierten Diagnoseinstrumente sind noch nicht validiert. Unser Ziel war es, das Spektrum der Hautläsionen bei Stomapatienten zu beschreiben und Risikofaktoren dafür zu identifizieren. Ein Schwerpunkt lag dabei auf peristomalen Ulzerationen und deren Abgrenzung zum peristomalen Pyoderma gangränosum.
Methoden In einer retrospektiven Analyse wurden Häufigkeit und Art der peristomalen Hautläsionen bei Patienten, die in zwei Abteilungen (Chirurgie und Dermatologie) vorgestellt wurden, untersucht. Patienten mit peristomalen Ulzerationen wurden einer detaillierteren Analyse unterzogen, bei der auch der PARACELSUS-Score zur Diagnostik eines peristomalen Pyoderma gangränosum angewandt wurde.
Ergebnisse Insgesamt wurden 565 Patienten mit Stoma analysiert. 40,2% (n = 227) wiesen peristomale Hautläsionen auf. Am häufigsten waren feuchtigkeitsbedingte Hautschäden (27,9%), während Ulzerationen (21,9%) und ekzematöse Hautveränderungen (19,1%) mit vergleichbarer Häufigkeit auftraten. Peristomales Pyoderma gangränosum wurde bei 7,9% aller beobachteten peristomalen Läsionen diagnostiziert. Bei Patienten mit entzündlichen Darmerkrankungen (n = 98) waren peristomale Ulzerationen der häufigste Befund (35,7%) und Pyoderma gangränosum war bei diesen Patienten häufiger (16,3%).
Schlussfolgerungen Es ist erforderlich, peristomale Hautläsionen zu beurteilen und zu klassifizieren. Weitere Studien zur Validierung verschiedener Scores oder zur Entwicklung von Diagnoseinstrumenten sind erforderlich.
Keywords
ostomy - inflammatory bowel disease - skin lesion - pyoderma gangrenosum - peristomal ulcerSchlüsselwörter
Stoma - chronisch entzündliche Darmerkrankung - Hautveränderung - Pyoderma gangränosum - peristomale UlzerationPublication History
Received: 15 February 2024
Accepted: 01 July 2024
Article published online:
29 July 2024
© 2024. Thieme. All rights reserved.
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