Case Review: Gentian Violet Solution for Peristomal Skin Breakdown

Case Review: Gentian Violet Solution for Peristomal Skin Breakdown

76 y/o Caucasian female in Northeast Wisconsin

Height:5’4”

Weight:181lbs

Stoma size:1"x1 3/4",retracted

Location:LUQ

Skin folds:3-9sitting

PMH/Timeline:

• Endometrial cancer
• Hysterectomy,Radiation-1998
• Vesicovaginal fistula
• Cystectomy with Urostomy-9/25/14

 

Dates	Peristomal Skin	Wear time (hours)	Treatments
9/2014-10/2016	Excellent	48	2 ¼”,2 piece pre-cut
11/2016-12/2016	“graying”,blistering,red	24-48	Various home treatments
1/5/17-6/6/17-outside facility	Red,weeping	12-48	2 piece,2 1/4",pre-cut,powder crusting, antifungal crusting,deep convexity 1 piece, custom ostomy belt for large pannus-not pursued by patient, ostomy belt, surgical revision suggested-not surgical candidate d/t surgical/ radiation history
7/13/17-First visit in facility	Red,weeping	12-24	Convex 2 ¼,2 piece,paste,crusting
7/27/17-8/14/17	Red,weeping,satellite lesions	12-48,variable	Oral fluconazole,2 ¼” convex 2 piece, 2 ¾” convex 2 piece,paste,nystatin crusting, 2” barrier ring,ostomy belt,Non-cytotoxic cyanoacrylate-based monomer skin protectant
8/18/17	Red,weeping	12-24	Inconsistent supplies used at home-2 ¼”-2 ¾” convex 2 piece. Gentian Violet 1%topical solution (GV) to peristomal skin, allowed to dry completely,Nystatin crusting,2 ¾” convex 2 piece,2”convex oval barrier ring, ostomy belt
8/23/17	Red,weeping skin-improving	12-24	GV to peristomal skin,dry. Recommended patient purchase GV OTC for home. Nystatin crusting to remaining weeping areas. 2 ¾” convex,2 piece with 1 whole 2” convex oval barrier ring,½ of 2” convex oval barrier ring stacked on bottom of barrier,ostomy belt.
9/8/17	Healed	48	Same from 8/23/17
10/6/17	Healed	48-96	Same except GV/ powder crusting PRN

Literature review: No literature available regarding use of GV solution in treating peristomal skin breakdown.

Conclusion: Stoma powder/antifungal powder and skin protectant crusting is common treatment for weeping/moist peristomal skin. After failed treatment with crusting, use of GV proved to be a valuable adjunctive treatment to traditional peristomal skin breakdown.

Recommendations: GV 1% topical solution is as an inexpensive OTC topical treatment option for peristomal skin breakdown. Further research regarding this treatment of peristomal skin breakdown is needed.