Pseudovercous lesions most directly indicate which process?

• A. Hyperplasia of peristomal skin
• B. Hyperkeratosis
• C. Granulomas
• D. Chronic papillomatous dermatitis

Answer: (A)

Pseudovercous lesions arise when peristomal skin is exposed to ongoing moisture and irritation from urine, stool, or appliance leaks. In response to that persistent irritation, the skin undergoes increased cell proliferation, leading to epidermal hyperplasia and the formation of thick, raised, wart-like plaques around the stoma. This hyperplastic reaction is the direct process behind these lesions. The other options reflect different skin processes (granulomatous inflammation, chronic papillomatous changes, or thickening from friction alone) but do not capture the primary peristomal epidermal proliferation driving pseudoverrucous lesions. Clinically, management focuses on eliminating moisture and irritation by ensuring a proper appliance seal and skin protection to halt the hyperplastic response.