Perianal pseudoverrucous papules and nodules in Hirschsprung's disease

Abstract

Perianal pseudoverrucous papules and nodules (PPPN) is an inflammatory skin reaction due to cutaneous irritation by factors favoring maceration and elevated pH. We report a case occurring after treatment of Hirschsprung's disease in a 16-month-old infant. Multiple fleshy oozing perianal nodules of 0.5 to 1 cm were found. The diagnosis of PPPN was retained on the clinical history and lesion appearance. Treatment consisted of frequent washing and diaper changes, and application of sucralfate lotion. Evolution was regressive over several months, concomitantly with improvement of intestinal transit.