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Chinese Herbal Retention Enema for the Treatment of Ulcerative Colitis

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Multiple perianal ulcers due to suppositories.

Francesco Savoia¹, Andrea Sechi¹, Michela Tabanelli²

¹Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.

The Australasian Journal of Dermatology

|July 25, 2018

Summary

This summary is machine-generated.

Long-standing perianal ulcers resolved after discontinuing frequent use of analgesic suppositories containing indomethacin, caffeine, and prochlorperazine dimaleate. This suggests medication-induced vascular damage may cause such ulcers.

Keywords:

caffeine indomethacin perianal ulcers prochlorperazine dimaleate suppositories

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Area of Science:

Gastroenterology
Pharmacology

Background:

Perianal ulcers can have various etiologies, including inflammatory, infectious, and neoplastic causes.
Unexplained chronic perianal ulcers pose a diagnostic challenge.

Observation:

A patient presented with long-standing, unexplained perianal ulcers.
Detailed history revealed frequent use of analgesic suppositories (indomethacin, caffeine, prochlorperazine dimaleate) for migraine management.

Findings:

Complete healing of perianal ulcers occurred within 12 weeks after cessation of the analgesic suppositories.
The study hypothesizes that the medication's ingredients may induce vasoconstriction and vascular damage, leading to ulcer formation.

Implications:

This case highlights the potential for topical analgesic suppositories to cause iatrogenic perianal ulcers.
Clinicians should consider medication history, particularly frequent use of vasoconstrictive agents, in the differential diagnosis of perianal ulcers.