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Perianal Ulcers from Antihemorrhoidal Ointment: A Case Report and Literature Review
Alejandro García-Irigoyen1, Simón Guzmán-Bucio, Juan Francisco Molina-López
1In Mexico City, Mexico, Alejandro García-Irigoyen, MD, is Dermatology Resident, Division of Dermatology, Hospital General Dr. Manuel Gea González; Simón Guzmán-Bucio, MD, is Undergraduate Researcher, Division of Dermatology, Hospital General Dr. Manuel Gea González; Juan Francisco Molina-López, MD, is Attending, Coloproctology Department, Centro Médico ABC; María Elisa Vega-Memije, MD, is Researcher and Head of the Division of Dermatology, Hospital General Dr. Manuel Gea González; and Adriana Lozano Platonoff, MD, is Researcher, Interdisciplinary Wound and Ostomy Care Center, Division of Dermatology, Hospital General Dr. Manuel Gea González.
Abstract:
Perianal ulcers (PAUs) related to antihemorrhoidal product use have been recently reported in the literature through a few case reports. However, other etiologies of PAU must be ruled out, including infectious disease, inflammatory disease, malignancy, pressure injuries, radiotherapy, and other topical drugs. In this report, the authors describe two cases of PAUs due to an antihemorrhoidal ointment. In case 1, a 68-year-old woman with a history of hemorrhoids presented with PAUs after using an antihemorrhoidal ointment for 2 months. The ulcers were assessed through a histopathologic study and treated with calcium alginate dressings, with complete re-epithelialization occurring after 2 months. In case 2, a 58-year-old woman with a history of hemorrhoids developed painful PAUs while using an antihemorrhoidal ointment for 2 months. No other probable cause was found, and the ulcers were treated by discontinuing the ointment. The ulcers showed marked improvement, and complete re-epithelialization occurred after 6 weeks without additional treatment.
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