Which practice is recommended for psoriasis management in peristomal skin?

• A. Use pouching system with hydrocolloid skin barrier only—no tape collars; all hydrocolloids to promote healing
• B. Apply adhesive tape collars for better adhesion
• C. Discontinue hydrocolloid entirely
• D. Change pouches hourly

Answer: (A)

When peristomal psoriasis is present, the goal is to protect the skin from trauma and friction while providing a gentle, shielding environment that supports healing. A pouching system that uses a hydrocolloid skin barrier only—without tape collars—achieves this by creating an occlusive, cushioned seal that protects the skin from stoma output and adhesive contact, reducing irritation and mechanical stress on the psoriatic plaques. Hydrocolloid barriers help maintain a moist environment that can promote healing of irritated skin.

Adding adhesive tape collars increases friction and pulling on already sensitive peristomal skin and can worsen irritation or trauma, which is why they’re not recommended in this context. Discontinuing hydrocolloid entirely would leave the skin unprotected and more prone to breakdown, and changing pouches hourly can disrupt the skin barrier and increase leakage risk without improving healing.