Table of Content

Current Issue

Autumn 2020, Vol. 28 No. 3

Hong Kong J. Dermatol. Venereol. (2020) 28, 121-124


Case Report

Pseudoverrucous papules and nodules in an elderly woman with encopresis: effects of cryotherapy

一名患有功能性大便失禁的老婦的假疣性丘疹和結節:冷凍療法的療效

A Tulin Mansur, S Ramadan, N Oguz

Abstract

Pseudoverrucous papules and nodules (PPN) is a type of irritant dermatitis, usually secondary to urinary incontinence or encopresis and may mimic several infectious, inflammatory, and neoplastic disorders. Although topical barrier agents have been used, the lesions regress only after the irritating factors are removed. Herein we report a 79-year-old woman with onset of PPN due to faecal incontinence after a cerebrovascular accident. Histopathological examination of the perianal and gluteal papulonodules confirmed the diagnosis of PPN. We treated the lesions with cryotherapy together with barrier creams, topical antibiotics and antiseptics. After five sessions of cryotherapy performed 3 weeks apart, a partial response was achieved. However, due to an episode of pneumonia, treatment was interrupted for three months during which the lesions relapsed. In conclusion, treatment of PPN should involve elimination of the precipitating factors, while destructive or surgical methods may only provide temporary relief.

假疣性丘疹和結節是一種刺激性皮炎,通常是由大小便失禁問題而衍生,並常被誤以為傳染性、炎性或腫瘤性疾病。儘管使用外用皮膚屏障劑,但需去除刺激性因素後病變才能消退。本文報導了一名79歲女性因腦血管意外後大便失禁而出現假疣性丘疹和結節,肛門周圍和臀部的組織病理學檢查確實此病。我們用冷凍療法配以皮膚屏障藥膏、外用抗生素和消毒劑進行治療。每三週一次供五次的冷凍治療後,患處情況得到部分改善。但是由於染上肺炎,治療被迫中斷了三個月,在此期間患處再度惡化。終括來說,此病治療必需併除促發的因素,而破壞性或外科手術等方法僅能提供暫時的舒緩。

Keywords: Encopresis, granuloma gluteale adultorum, incontinence, peristomal skin, pseudoverrucous papules and nodules

關鍵詞: 功能性大便失禁、成人臀部肉芽腫、失禁、造口周邊皮膚、假疣性丘疹和結節