Chronic ulcerative lesion with peristomal involvement: a diagnostic challenge

An 89-year-old man presented to the dermatology clinic with a progressively worsening ulcerated lesion around his peristomal site. He had a long-standing ileal conduit in place for 11 years and, initially, a mild erythematous rash developed around the stoma site. Over the course of a few months, the area became increasingly painful, irritated and tender. Despite conservative management, including proper stoma care and the use of topical barrier creams and topical steroids, the lesion failed to improve.