This topic is about dealing with chronic Pseudomonas folliculitis and persistent rashes around the stoma area for someone with an ileostomy. The person has been experiencing these issues since their surgery for rectal cancer and is looking for advice on how to manage and minimize these skin problems. Here are some helpful insights and advice shared by others:

1. Differential Diagnosis & Medical Therapy
- Make sure the skin issue is correctly identified, whether it's bacterial, fungal, or allergic.
- Treatments prescribed by specialists include Hydrocortisone cream, Nystatin powder, oral or topical antibiotics, and Arglaes Antimicrobial powder.
- If yeast treatments don't work, consider re-culturing the skin.

2. Appliance Choice & Wafer Materials
- Some adhesives can cause rashes; switching to pectin-based wafers or convex systems may help.
- For stomas that are recessed or flush, using convex wafers with a moldable barrier ring can prevent leaks and protect the skin.

3. Crusting Technique for Damaged Skin
- Clean the area with warm water and dry it thoroughly.
- Apply Stomahesive or Nystatin powder, then dab with a Cavilon barrier wipe or spray and let it dry.
- Repeat the powder and Cavilon application to form a crust before applying the wafer.

4. Barrier Products for Protection
- Cavilon barrier wipes or sprays can prevent irritation on healthy skin.
- Zinc-oxide creams like Desitin or Butt Paste can be used under the wafer.
- Duoderm hydrocolloid squares or Stoma Seal can be helpful and cost-effective.

5. Full Application Sequence
- Remove the appliance, cleanse, and dry the skin.
- Apply stoma powder and Cavilon for crusting.
- Warm an Eakin Seal with a hair-dryer and mold it around the stoma.
- Apply a convex wafer and press it for 10-15 minutes to activate the adhesive.
- Optionally, add a strip of barrier paste between the crusted skin and the ring.
- Attach the pouch, with a typical wear-time of 3-4 days.

6. Frequency of Changes
- Change the appliance every 48-72 hours or at the first sign of itching to prevent leaks and bacterial contamination.

7. Home/Alternative Measures
- Use a baking-soda paste on the rash for relief, though it may sting initially.
- Probiotic capsules or live-culture yogurt might help balance gut flora.

8. Output-Control Tips During Changes
- Eating 4-6 marshmallows before removing the appliance can slow the ileostomy flow for better skin care.

9. Handling Pouch "Burping"
- Properly sealed flanges should prevent feces from spraying during gas release. Always wash hands after burping the pouch.

10. Pain & Quality of Life
- Persistent pain may require short-term pain relief. Severe dermatitis should be reviewed by a nurse or may need stoma relocation.