‘Granuloma gluteale’ affecting an ileostomy site

Published: 02/20/2012

Authors: Lyon CC and Chintapatla S

A 30-year-old man had subtotal colectomy/ileostomy for Crohn’s disease. He later developed inflammatory papules around his stoma which could no longer be accommodated by the largest appliance. He was immunosuppressed following renal transplantation.

Such lesions are commonly seen around leaking stomas in response to faecal irritation. They are analogous to severe napkin dermatitis which is exacerbated by occlusion and topical steroids that promote bacterial overgrowth. Occlusion and immunosuppression probably caused the remarkable proliferation in our patient. He remains asymptomatic one year after resection.