The challenges in the management of a stoma patient with Dermatitis Artefacta

Mrs Mireille  Hamson1
1Salts Healthcare, Aston, United Kingdom


Skin integrity is crucial for skin health in stoma care and patients quality of life. In reality, peristomal skin complications are common and will effect 30-60% of stoma patients (Birch 2008). It is important to maintain healthy peristomal skin and this can be achieved through a peristomal skin assessment.  A peristomal skin assessment in vital for recognition and prompt appropriate treatments of these conditions.


The purpose of this study is to discuss the challenges of Dermatitis Artefacta (DA). DA is a condition where lesion appear on the skin, that are produced or inflicted by the patient’s own actions, but the patient denies the self-harmed. It is a rare dermatological disorder, but it can often be difficult to diagnose and poorly understood by health professionals. We will demonstrate how a stoma patient with DA was managed in our stoma department and how this experienced has increased our knowledge and understanding of this rare disorder in stoma care.


The case study will highlight the patient’s journey through the stoma care pathway and the delivery of care. It will demonstrate both physical and psychological challenges experienced by the hospital and community stoma teams, when caring for an individual with DA – indicating the importance of a team approach and collaboration in stoma management.


The management of a patient with DA is extremely challenging and multifaceted. There is very little evidence of DA in relation to stoma care and treatment can be varied. Patients with this condition can have significant impact on the stoma care service, due to their attention seeking behaviour

and complicated stoma issues. A clear strategy of stoma management is required to supervise and support both the patient’s physical and emotional issues.


I have been a Stoma Care Nurse for the last 18 years in the UK. I currently work for Salts Healthcare as a Clinical Nurse Specialist in Innovation and practice 2 days a week as a Community Stoma Nurse.