When would active psoriasis around the stoma most commonly emerge?

• A. 1-2 weeks after epidermal injury or local trauma around the stoma
• B. Immediately after stoma creation
• C. Months after surgery
• D. Only with sun exposure

Answer: (A)

Psoriasis around the stoma often appears due to the Koebner phenomenon, where skin injury or local trauma triggers psoriatic plaques in people who are susceptible. The peristomal area is prone to trauma from appliance changes, adhesion removal, friction, moisture, or minor skin injuries. This type of trauma typically leads to new psoriatic lesions about 1–2 weeks after the epidermal injury, which is why that timing is most commonly seen.

Immediate appearance right after stoma creation is unlikely because a trigger hasn’t yet occurred. Months after surgery could happen if ongoing irritation continues, but the typical pattern is the 1–2 week window following an injury. Sun exposure alone is not the usual trigger for peristomal psoriasis.