Psoriasis First Presenting Around an Enteral Feeding Tube in Three Pediatric Patients: An Important Consideration for Timely Diagnosis and Management

Abstract

Pediatric dermatologists may care for patients with percutaneous enteral feeding tubes. Although ostomy complications such as allergic contact and irritant dermatitis are common, psoriasis may be misdiagnosed. We report three novel cases of childhood psoriasis first presenting around an enteral feeding tube site. Localized psoriasis is an important clinical consideration in children with ostomy site eruptions to ensure timely diagnosis and effective management.

Koebner Phenomenon

“…Both lesions were pruritic. The erythematous plaque with silvery scale surrounding the G‐tube site and on the right dorsal hand are clinically consistent with plaque psoriasis, which may be occurring in areas of injury or chronic irritation caused by the Koebner phenomenon (1).…”

Peristomal psoriasis

“…Abdominal stomas represent a specific site where psoriasis may develop, and the presentation of psoriasis may be subtle elsewhere, contributing to under‐recognition of the condition . Psoriasis may even be limited to the stomal site and present initially at this before becoming apparent at more typical sites . The aim of our study was to assess the prevalence of peristomal psoriasis in our dedicated stoma clinic and to identify an effective treatment regimen.…”

“…3 Psoriasis may even be limited to the stomal site and present initially at this before becoming apparent at more typical sites. 4,5 The aim of our study was to assess the prevalence of peristomal psoriasis in our dedicated stoma clinic and to identify an effective treatment regimen.…”