Human papillomavirus-negative ileostomal chronic papillomatous dermatitis.
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.
Williams
Christy M
CM
Department of Pathology, University of South Alabama College of Medicine, Mobile, Alabama, USA.
Wieland
Ulrike
U
Rodning
Charles B
CB
Horenstein
Marcelo G
MG
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*
D004279:DNA, Viral