title: Human papillomavirus-negative ileostomal chronic papillomatous dermatitis.
abstract: BACKGROUND
  Papillomatous stoma-related skin lesions may result from irritant reactions or infection with epidermodysplasia verruciformis human papillomavirus (HPV) types.
  
  
  METHODS
  We report upon a papillomatous lesion at the ileostoma of a 63-year-old male with familial adenomatous polyposis and colorectal adenocarcinoma. We thoroughly tested the lesion for HPV using immunohistochemistry, transmission electron microscopy, and polymerase chain reaction analyses.
  
  
  RESULTS
  The lesion was a fleshy, multilobulated, and verrucous plaque, with hyperkeratosis, hypergranulosis, acanthosis and marked papillomatosis. The clinical and light microscopic features were suggestive of a condyloma. However, no HPV was detected.
  
  
  CONCLUSIONS
  We suggest that the lesion most likely represents chronic papillomatous dermatitis, a reaction to mechanical and/or chemical irritation usually associated with urostomies and only rarely observed with ileostomies. This case highlights the clinical, diagnostic and therapeutic aspects of an unusual cutaneous morbidity associated with ileostomies.
authors.affiliation: Department of Pathology, University of South Alabama College of Medicine, Mobile, Alabama, USA.
authors.forename: Christy M
authors.initials: CM
authors.lastname: Williams
authors.forename: Ulrike
authors.initials: U
authors.lastname: Wieland
authors.forename: Charles B
authors.initials: CB
authors.lastname: Rodning
authors.forename: Marcelo G
authors.initials: MG
authors.lastname: Horenstein
mesh_terms: D002908:Chronic Disease; D004279:DNA, Viral / Q000032:analysis; D003872:Dermatitis / Q000209:etiology / Q000473:pathology*; D006801:Humans; D007081:Ileostomy; D008297:Male; D008875:Middle Aged; D010212:Papilloma / Q000209:etiology / Q000473:pathology*; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D054047:Surgical Stomas / Q000473:pathology*
chemical_list: D004279:DNA, Viral