Which statement best describes a factor that commonly contributes to peristomal irritant dermatitis?

• A. Allergic reaction to adhesives
• B. Poor fitting/leaking appliances - effluent causing irritation
• C. Moisture alone
• D. Chemical sensitivity unrelated to appliance fit

Answer: (B)

Peristomal irritant dermatitis is most often caused by direct contact of the skin with effluent from an ill-fitting or leaking ostomy appliance. When the flange doesn’t seal properly or the pouch leaks, stool or urine (with enzymes, ammonia, and other irritants) sits against the skin and breaks down the skin barrier, triggering inflammation, redness, and itching around the stoma. Fixing the fit and eliminating leaks stops the source of irritation and allows the skin to heal.

Moisture or chemical sensitivities can contribute, but they’re less likely to be the main, ongoing cause unless the appliance is fitting poorly or leaking. Allergic reactions to adhesives can occur, but the most common and preventable contributor is effluent contact due to inadequate appliance seal.