title: Effects of potato-derived protease inhibitors on perianal dermatitis after colon resection for long-segment Hirschsprung's disease.
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.
  
  
  CONCLUSIONS
  The results of the study suggest that PPI may reduce otherwise intractable protease-induced skin irritation in infants.
authors.affiliation: Department of Pediatric Surgery, Children's University Hospital, Inselspital, University of Bern, Bern, Switzerland. steffen.berger@insel.ch
authors.forename: Steffen
authors.initials: S
authors.lastname: Berger
authors.forename: Janine
authors.initials: J
authors.lastname: Rufener
authors.forename: Peter
authors.initials: P
authors.lastname: Klimek
authors.forename: Zacharias
authors.initials: Z
authors.lastname: Zachariou
authors.forename: Colette
authors.initials: C
authors.lastname: Boillat
mesh_terms: D001003:Anal Canal; D002675:Child, Preschool; D003106:Colon / Q000601:surgery*; D003872:Dermatitis / Q000188:drug therapy*; D006627:Hirschsprung Disease / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000188:drug therapy*; D011446:Prospective Studies; D011480:Protease Inhibitors / Q000627:therapeutic use*; D011198:Solanum tuberosum
chemical_list: D011480:Protease Inhibitors