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Cholestyramine ointment to treat buttocks rash and anal excoriation in an infant

C M White1, R A Gailey, S Lippe

  • 1Albany College of Pharmacy, NY 12208, USA.

The Annals of Pharmacotherapy
|September 1, 1996
PubMed

Insights

A novel topical cholestyramine ointment effectively treated infant perianal excoriation caused by bile acids from cisapride. This treatment rapidly resolved the severe rash and irritation within three days.

Area of Science:

  • Pediatric Gastroenterology
  • Dermatology
  • Pharmacology

Background:

  • Infants with gastrointestinal motility disorders often receive promotility agents.
  • Cisapride, a promotility agent, can alter bile acid metabolism.
  • Perianal excoriation is a challenging condition in infants.

Observation:

  • A 2-month-old infant treated with cisapride developed severe perianal rash and irritation.
  • Standard topical treatments and diaper-free periods were ineffective.
  • A novel topical cholestyramine ointment was prepared and applied.

Findings:

  • Topical cholestyramine ointment led to complete resolution of perianal excoriation within 3 days.
  • Cholestyramine, a bile acid sequestrant, binds bile acids topically.
  • This mechanism addresses the presumed etiology of irritation from altered bile acid reabsorption.

Implications:

  • Topical cholestyramine may be a safe and effective treatment for drug-induced perianal irritation.
  • Understanding bile acid dynamics is crucial in managing infant skin conditions.
  • This approach offers a potential solution for refractory perianal dermatitis in infants.
Abstract

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