Pseudoverrucous papules and nodules in an elderly woman with encopresis: effects of cryotherapy

Abstract

Pseudoverrucous papules and nodules (PPN) is a type of irritant dermatitis, usually secondary to urinary incontinence or encopresis and may mimic several infectious, inflammatory, and neoplastic disorders. Although topical barrier agents have been used, the lesions regress only after the irritating factors are removed. Herein we report a 79-year-old woman with onset of PPN due to faecal incontinence after a cerebrovascular accident. Histopathological examination of the perianal and gluteal papulonodules confirmed the diagnosis of PPN. We treated the lesions with cryotherapy together with barrier creams, topical antibiotics and antiseptics. After five sessions of cryotherapy performed 3 weeks apart, a partial response was achieved. However, due to an episode of pneumonia, treatment was interrupted for three months during which the lesions relapsed. In conclusion, treatment of PPN should involve elimination of the precipitating factors, while destructive or surgical methods may only provide temporary relief.