A man in his 60s presented with a 2-month history of an asymptomatic peristomal rash. A colostomy had been performed 1 year previously on the left side of the abdomen in the setting of adenocarcinoma of the colon. He had a known history of mild plaque psoriasis for several years, controlled with topical corticosteroids. A skin examination revealed sharply demarcated erythematous plaques of different sizes, with silvery scale, distributed concentrically around the stoma (Figure), beneath and beyond the adhesive tape used to affix the colostomy bag. Psoriatic lesions were present on his elbows and legs. The patient had previously been treated with moisturizers and topical antifungal creams by his enterostomal nurse without any improvement. A clinical diagnosis of peristomal koebnerization of psoriasis was made. The patient was treated with 0.005% calcipotriol/0.05% betamethasone dipropionate gel, with complete healing of all lesions.
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Caldas R, Guimarães MJ, Pereira T. Colostomy Bag–Induced Koebner Phenomenon. JAMA Dermatol. Published online May 27, 2020. doi:10.1001/jamadermatol.2020.1077
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