Úlceras perianales que no se curan debido al abuso de una pomada hemorroidal

Perianal Ulcers from Antihemorrhoidal Ointment: A Case Report and Literature Review

“…Consistent with other reported cases of PAU induced by antihemorrhoidal ointments, laboratory tests and histology did not support any other diagnosis. Discontinuing the ointment resulted in rapid improvement of the ulcers, further supporting the ointment as the cause of the lesions 4–6 . However, PAUs are a diagnosis of exclusion, as there is no consensus on specific diagnostic criteria.…”

“…Overall, the time between the start of ointment use and the development of lesions is 8 to 32 weeks (Table ). [4][5][6] In addition, one case reported PAU induced by betamethasone dipropionate 0.05% and clotrimazole 1% after 12 weeks. 7 The active ingredient most likely responsible for skin damage in antihemorrhoidal ointments is topical steroids, as observed in these two cases with hydrocortisone acetate and in other reported cases involving triamcinolone and betamethasone dipropionate.…”

“…Discontinuing the ointment resulted in rapid improvement of the ulcers, further supporting the ointment as the cause of the lesions. [4][5][6] However, PAUs are a diagnosis of exclusion, as there is no consensus on specific diagnostic criteria. Clinically, PAUs present as symmetrically distributed ulcers with delimited borders.…”

“…In these cases, re-epithelialization occurred within 6 to 8 weeks, which is similar to the resolution time reported in previous studies, generally from 6 to 9 weeks. [4][5][6] It is concerning that antihemorrhoidal ointments are suddenly leading to PAUs despite being available for more than 10 years. Other countries have reported similar adverse effects.…”

“…Overall, the time between the start of ointment use and the development of lesions is 8 to 32 weeks (Table). 4–6 In addition, one case reported PAU induced by betamethasone dipropionate 0.05% and clotrimazole 1% after 12 weeks 7…”