Tratando a dermatite irritativa periestomal com terapia a laser de baixa potência: relato de caso

Cristhiane de Souza Silveira; Rosaura Soares Paczek; Vania Celina Dezoti Micheletti; Luciani Aparecida da Silva Melo

Authors

Cristhiane de Souza Silveira Escola de Saúde Pública do Rio Grande do Sul – Porto Alegre (RS), Brazil. https://orcid.org/0000-0001-7924-307X
Rosaura Soares Paczek Prefeitura Municipal de Porto Alegre – Porto Alegre (RS), Brazil. https://orcid.org/0000-0002-4397-1814
Vania Celina Dezoti Micheletti Escola de Saúde Pública do Rio Grande do Sul – Porto Alegre (RS), Brazil. https://orcid.org/0000-0003-1254-7479
Luciani Aparecida da Silva Melo Prefeitura Municipal de Porto Alegre – Porto Alegre (RS), Brazil. https://orcid.org/0000-0002-1220-1526

Abstract

Objective: To report the clinical case of a patient with an ileostomy who underwent Low-Level Laser Therapy (LLLT) for the treatment of peristomal dermatitis.

Method: This is a case study conducted in an ostomy care service in southern Brazil in 2025, following the Case Report (CARE) guidelines of the Enhancing the Quality and Transparency of Health Research. Data were collected during 11 outpatient consultations, including clinical assessment of the peristomal lesion, measurement with a ruler, serial photographic records, and analysis of the electronic medical record.

Results: A 28-year-old female patient, diagnosed with cervical cancer in 2024, was treated with radiotherapy and brachytherapy. She subsequently developed actinic colitis, rectal stenosis, and a rectovaginal fistula, requiring an ileostomy. The patient presented with peristomal dermatitis, pain, weakness, and difficulty in securing the ostomy appliance. Treatment with LLLT was initiated, resulting in progressive improvement of the skin condition and better adhesion of the ostomy appliance. Throughout follow-up, cutaneous recovery was observed, with reduction of dermatitis and improvement in overall condition.

Conclusion: LLLT proved effective in the treatment of peristomal dermatitis in a patient with an ileostomy, promoting rapid skin recovery, improved adhesion of the ostomy appliance, and relief of symptoms. The intervention significantly contributed to the patient’s rehabilitation and quality of life, highlighting its importance as a complementary resource in ostomy care.

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References

Santana JTS, Santana EMS, Ribeiro TLL, Ferreira RKC. A aplicabilidade da radioterapia no tratamento do câncer de colo de útero. RECIMA21. 2024;5(8):e585489. https://doi.org/10.47820/recima21.v5i8.5489

Vaidya JS. Principles of cancer treatment by radiotherapy. Surgery. 2024;42(3):139-49. https://doi.org/10.1016/j.mpsur.2023.12.001

Al Morris K, Haboubi NY. Pelvic radiation therapy: between delight and disaster. World J Gastrointest Surg. 2015;7(11):279-88. https://doi.org/10.4240/wjgs.v7.i11.279

Dohm A, Sanchez J, Stotsky-Himelfarb E, Willingham FF, Hoffe S. Strategies to minimize late effects from pelvic radiotherapy. Am Soc Clin Oncol Educ Book. 2021;41:158-68. https://doi.org/10.1200/EDBK_320999

Edwards DM, Jolly S. External beam management of stage I and II uterine cancer. Int J Gynecol Cancer. 2022;32(3):297-303. https://doi.org/10.1136/ijgc-2021-002472

Ahmed M, Ahmed R. Radiation in gastroenterology. Gastroenterology Res. 2022;15(6):285-96. https://doi.org/10.14740/gr1567

Xiao J, Li QD. Multi-slice spiral CT evaluation of chronic radiation colitis and rectitis. Exp Ther Med. 2020;20(4):3033-40. https://doi.org/10.3892/etm.2020.9069

Yuan ZX, Ma TH, Wang HM, Zhong QH, Yu XH, Qin QY, et al. Colostomy is a simple and effective procedure for severe chronic radiation proctitis. World J Gastroenterol. 2016;22(24):5598-608. https://doi.org/10.3748/wjg.v22.i24.5598

Zelga P, Tchórzewski M, Zelga M, Sobotkowski J, Dziki A. Radiation-induced rectovaginal fistulas in locally advanced gynaecological malignancies-new patients, old problem? Langenbecks Arch Surg. 2017;402(7):1079-88. https://doi.org/10.1007/s00423-016-1539-4

Huang XY, Zhong Q, Wang H, Zhao J, Kuang Y, Guan Q, et al. Diverting colostomy is an effective procedure for ulcerative chronic radiation proctitis patients after pelvic malignancy radiation. BMC Surg. 2020;20(1):267. https://doi.org/10.1186/s12893-020-00925-2

Collado-Boira E, Boldo-Roda P, Bernat-Adell MD, Morar KG, Ayora AF, Medina PS. Effectiveness of semiocclusive sodium carboxymethyl cellulose fibers and hydrocolloid dressings for irritant peristomal dermatitis: a case series. Adv Skin Wound Care. 2021;34(9):493-7. https://doi.org/10.1097/01.ASW.0000767336.91651.67

Steinhagen E, Colwell J, Cannon LM. Intestinal stomas-postoperative stoma care and peristomal skin complications. Clin Colon Rectal Surg. 2017;30(3):184-92. https://doi.org/10.1055/s-0037-1598159

Santana LS, Nunes MLG, Santos VLCG. Prevalence of peristomal dermatitis–related pain: a cross-sectional study. Pain Manag Nurs. 2025;26(6):e575-e583. https://doi.org/10.1016/j.pmn.2025.04.014

Lucena AF, Bavaresco T, Menegon DB, Schneider SMB, Medeiros RM, Souza CMB. Laser em feridas: translação do conhecimento para uma prática efetiva e inovadora na enfermagem. Rev Gaúcha Enferm. 2021;42:e20200396. https://doi.org/10.1590/1983-1447.2021.20200396

Santos TL, Costa BCPF, Costa CV, Gomes EB, Ripardo LSS, Quaresma OB, et al. Importância da laserterapia no tratamento de feridas. REAEnf. 2021;15:e9078. https://doi.org/10.25248/reaenf.e9078.2021

Bavaresco T, Osmarin VM, Pires AUB, Moraes VM, Lucena AF. Terapia a laser de baixa potência na cicatrização de feridas. Rev Enferm UFPE on line. 2019;13(1):216-26. https://doi.org/10.5205/1981-8963-v01i01a235938p216-226-2019

Guerra E, Denti FC, Di Pasquale C, Caroppo F, Angileri L, Cioni M et al. Peristomal skin complications: detailed analysis of a web-based survey and predictive risk factors. Healthcare (Basel). 2023;11(13):1823. https://doi.org/10.3390/healthcare11131823

Zhang X, Xu W, Xu Z, Tong HHY, Jiao X, Li K, et al. Diagnosis of irritant dermatitis in colorectal cancer postoperative stoma patients using smartphone photographs: a deep learning approach. J Multidiscip Healthc. 2025;18:2215-23. https://doi.org/10.2147/JMDH.S515644

Salomé GM, Dutra RAA, Proença GD, Moreira KR. Estoma intestinal e os cuidados de enfermagem para prevenir e tratar as complicações da pele periestoma intestinal: revisão integrativa da literatura. GeSec. 2024;15(11):1-23. https://doi.org/10.7769/gesec.v15i11.4266

Salvadalena G, Colwell JC, Skountrianos G, Pittman J. Lessons learned about peristomal skin complications: secondary analysis of the ADVOCATE trial. J Wound Ostomy Continence Nurs. 2020;47(4):357-63. https://doi.org/10.1097/WON.0000000000000666

Otsuka ACVG, Moreira CLV, Pasquarelli EW, Pavani KCP, Anjos PP, Hashimoto SY, et al. Low-level laser therapy in the management of skin wound healing. Rev Bras Cir Plást. 2022;37(4):451-6. https://doi.org/10.5935/2177-1235.2022RBCP.640-en

Santos AF, Lopes Junior HMP, Silva LG. O papel fundamental dos enfermeiros na aplicação da fotobiomodulação no tratamento de feridas: perspectivas e práticas. REASE. 2024;10(9):3101-16. https://doi.org/10.51891/rease.v10i9.15746