What is a GI ostomy–specific treatment for hyperplasia/pseudoverrucous lesions?

• A. Corrected sizing and cutting of pouch system
• B. Crusting of lesions
• C. Chemical cauterization- silver nitrate
• D. Topical antibiotics

Answer: (A)

Managing peristomal skin irritation from leakage is the key idea here. Hyperplasia and pseudoverrucous lesions arise when peristomal skin is chronically exposed to moisture and irritants from ostomy output. The most effective GI ostomy–specific treatment is correcting the appliance fit by properly sizing and cutting the pouch opening to match the stoma. When the opening is too large or the barrier doesn’t seal well, stool leaks onto the skin, sustaining moisture and friction that keep the lesions going; a precisely sized opening reduces skin contact and leakage, allowing the skin to heal. After addressing fit, use a good skin barrier and, if needed, protective measures around the stoma. Treatments like crusting, chemical cauterization with silver nitrate, or topical antibiotics tackle symptoms or other issues rather than the root cause, which is ongoing irritation from an ill-fitting appliance.