A. Radiation burns

  • Skin changes from radiation burns can involve faint erythema and peeling of the skin or skin necrosis depending on the severity of the reaction. 
Radiation burn on lighter skin tone.
  • Radiation burns are often categorized as acute radiation dermatitis or chronic radiation dermatitis. 
Acute radiation dermatitis
Chronic radiation dermatitis in Fitzpatrick skin type II. Source of image is https://dermnetnz.org/topics/radiation-dermatitis
Chronic radiation dermatitis in Fitzpatrick skin type III. Source of image is https://dermnetnz.org/topics/radiation-dermatitis

B. Ostomy Complications

i. Adverse reactions to adhesive on the stoma bag

  • Negative skin reactions to adhesive can be due to mechanical trauma from removal of the stoma bag or due to an allergic reaction to the adhesive that causes contact dermatitis. Contact dermatitis presents with erythema and edema. In patients with lighter skin tones, this looks like red, raised patches of skin. In patients with darker skin tones the patches of skin are still raised but they may present as a dark purple color or a shade darker than their skin tone. Contact dermatitis may also present with oozing, crusty skin and blisters.2
Contact dermatitis from adhesive on a stoma bag in a patient with Fitzpatrick skin type I.

ii. Fungal Rash

  • Fungal infections around ostomies are typically due to the candida albicans fungus. These infections present with erythema and dry, erosive skin that is often scaly. In darker skinned individuals this will present as a dark purple color or a shade darker than their skin tone. In contrast, lighter skinned individuals will present with a red color. These infections can also present with cystic, raised spots or small, inflamed blisters.1  
Fungal rash in a patient with Fitzpatrick skin type II.

 

References:

  1. Palese E, Nudo M, Zino G, et al. Cutaneous candidiasis caused by Candida albicans in a young non-immunosuppressed patient: an unusual presentation. Int J Immunopathol Pharmacol. 2018;32:2058738418781368. doi:10.1177/2058738418781368 
  2. Li Y, Li L. Contact Dermatitis: Classifications and Management. Clin Rev Allergy Immunol. 2021;61(3):245-281. doi:10.1007/s12016-021-08875-0

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