Multiple perianal ulcers due to suppositories.

Francesco Savoia, Andrea Sechi, Michela Tabanelli, Silvia Zago, Miriam Leuzzi, Carlotta Baraldi, Annalisa Patrizi

Journal: The Australasian journal of dermatology 2019;60(1):50-52

PMID: 30039854

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Abstract

We report a case of long-standing inexplicable perianal ulcers. After exclusion of an inflammatory, infectious or neoplastic origin, a thorough personal history revealed that for many years the patient had been using analgesic suppositories containing indomethacin, caffeine, and prochlorperazine dimaleate, four to five times a week, for migraine. On stopping the suppositories, there was complete healing within 12 weeks. We hypothesize that vasoconstriction and vascular damage were the pathogenetic mechanisms behind the perianal ulcers.

Address: Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.; Unit of Dermatology, AUSL della Romagna, Ravenna, Italy.; Pathologic Anatomy Unit, AUSL della Romagna, Ravenna, Italy.

DOI: 10.1111/ajd.12888

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MeSH Terms: Aged, Anti-Inflammatory Agents, Non-Steroidal, Anus Diseases, Caffeine, Central Nervous System Stimulants, Chronic Disease, Dopamine Antagonists, Drug Combinations, Female, Humans, Indomethacin, Prochlorperazine, Skin Ulcer, Suppositories