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Effects of potato-derived protease inhibitors on perianal dermatitis after colon resection for long-segment Hirschsprung’s disease

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Abstract

Background

After resection of long-segment Hirschsprung’s disease, severe perianal dermatitis (SPAD) may occur because of high stool frequency and elevated concentrations of fecal pancreatic proteases. We investigated prospectively the effect of potato-derived protease inhibitors (PPI) on skin conditions in children with postoperative SPAD.

Methods

Four children (aged 12 to 24 months) with therapy-resistant SPAD after transanal endorectal pull-through for long-segment Hirschsprung’s disease received topical PPI (1% in 20% zinc ointment) with each diaper-change. Parents noted down a subjective dermatitis score daily. Photo documentation and outpatient visits were made to assess the treatment results.

Results

No adverse effects were observed after treatment with PPI. A remarkable improvement of the dermatitis in 3 of the 4 patients as well as improvements in pain and sleep disorders were observed during the PPI-treatment course.

Conclusion

The results of the study suggest that PPI may reduce otherwise intractable protease-induced skin irritation in infants.

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References

  1. Escobar MA, Grosfeld JL, West KW, Scherer LR, Rouse TM, Engum SA, et al. Long-term outcomes in total colonic aganglionosis: a 32-year experience. J Pediatr Surg 2005;40:955–961.

    Article  PubMed  Google Scholar 

  2. Wildhaber BE, Teitelbaum DH, Coran AG. Total colonic Hirschsprung’s disease: a 28-year experience. J Pediatr Surg 2005;40:203–206.

    Article  PubMed  Google Scholar 

  3. Rodriguez Cano L, Garcia-Patos Briones V, Pedragosa Jove R, Castells Rodellas A. Perianal pseudoverrucous papules and nodules after surgery for Hirschsprung disease. J Pediatr 1994;125:914–916.

    Article  PubMed  CAS  Google Scholar 

  4. Rodriguez-Poblador J, Gonzalez-Castro U, Herranz-Martinez S, Luelmo-Aguilar J. Jacquet erosive diaper dermatitis after surgery for Hirschsprung disease. Pediatr Dermatol 1998;15:46–47.

    Article  PubMed  CAS  Google Scholar 

  5. Bourrat E, Vaquin C, Prigent F, Rybojad M. Perianal papulonodular dermatitis in Hirschsprung disease. Ann Dermatol Venereol 1996;123:549–551.

    PubMed  CAS  Google Scholar 

  6. Langer JC, Seifert M, Minkes RK. One-stage Soave pull-through for Hirschsprung’s disease: a comparison of the transanal and open approaches. J Pediatr Surg 2000;35:820–822.

    Article  PubMed  CAS  Google Scholar 

  7. Langer JC, Durrant AC, de la Torre L, Teitelbaum DH, Minkes RK, Caty MG, et al. One-stage transanal Soave pullthrough for Hirschsprung disease: a multicenter experience with 141 children. Ann Surg 2003;238:569–583.

    PubMed  Google Scholar 

  8. Teitelbaum D, Coran A. Primary pull-through in the newborn. Seminars Pediatr Surg 1998;7:103–107.

    CAS  Google Scholar 

  9. Zhang SC, Bai YZ, Wang W, Wang WL. Clinical outcome in children after transanal 1-stage endorectal pull-through operation for Hirschsprung disease. J Pediatr Surg 2005;40:1307–1311.

    Article  PubMed  Google Scholar 

  10. Till H, Heinrich M, Schuster T, V Schweinitz D. Is the anorectal sphincter damaged during a transanal endorectal pull-through (TERPT) for Hirschsprung’s disease? A 3-dimensional, vector manometric investigation. Eur J Pediatr Surg 2006;16:188–191.

    Article  PubMed  CAS  Google Scholar 

  11. Layer P, Keller J. Pancreatic enzymes: secretion and luminal nutrient digestion in health and disease. J Clin Gastroenterol 1999;28:3–10.

    Article  PubMed  CAS  Google Scholar 

  12. Layer P, Go V, DiMagno E. Fate of pancreatic enzymes during small intestinal aboral transit in humans. Am J Physiol 1986;251:475–480.

    Google Scholar 

  13. Gibson S, McFarlan C, Hay S, MacFarlane G. Significance of microflora in proteolysis in the colon. App Environ Microbiol 1989;55:679–683.

    CAS  Google Scholar 

  14. Ruseler-van Embden JG, van Lieshout LM, Smits SA, van Kessel I, Laman JD. Potato tuber proteins efficiently inhibit human faecal proteolytic activity: implications for treatment of peri-anal dermatitis. Eur J Clin Invest 2004;34:303–311.

    Article  PubMed  CAS  Google Scholar 

  15. Atherton DJ. A review of the pathophysiology, prevention and treatment of irritant diaper dermatitis. Curr Med Res Opin 2004;20:645–649.

    Article  PubMed  Google Scholar 

  16. Halbert AR, Chan JJ. Anogenital and buttock ulceration in infancy. Australas J Dermatol 2002;43:1–6.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatric Surgery, Children’s University Hospital, Inselspital, University of Bern, CH-3010, Bern, Switzerland

    Steffen Berger, Janine Rufener, Peter Klimek, Zacharias Zachariou & Colette Boillat

Authors
  1. Steffen Berger
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  2. Janine Rufener
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  3. Peter Klimek
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  4. Zacharias Zachariou
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  5. Colette Boillat
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Correspondence to Steffen Berger.

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Berger, S., Rufener, J., Klimek, P. et al. Effects of potato-derived protease inhibitors on perianal dermatitis after colon resection for long-segment Hirschsprung’s disease. World J Pediatr 8, 173–176 (2012). https://doi.org/10.1007/s12519-012-0356-2

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  • DOI: https://doi.org/10.1007/s12519-012-0356-2

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