# Pseudoverrucous Papules and Nodules in the Perianal Area: A Case Report

## TL;DR

A 13-year-old boy with multiple health conditions developed a rare skin condition called pseudoverrucous papules and nodules near his anus, which was successfully managed with specific skin care.

## Contribution

This case report adds to the limited literature on pseudoverrucous papules and nodules in pediatric patients with complex medical conditions.

## Key findings

- PPN can occur in children with imperforate anus and Hirschsprung’s disease due to prolonged moisture exposure.
- Topical treatments like zinc oxide and tacrolimus 0.03% helped resolve the lesions over four months.
- Early recognition and preventive measures are crucial for managing PPN effectively.

## Abstract

Pseudoverrucous papules and nodules (PPN) is a rare form of irritant contact dermatitis caused by chronic exposure to moisture and irritants. It commonly affects individuals with urostomy sites, perianal dermatitis, or peristomal irritation due to incontinence. Clinically, PPN presents as flat-topped, erythematous papules and verrucous nodules, which can resemble infectious or neoplastic conditions, making diagnosis challenging. This case report describes a 13-year-old boy with trisomy 21, imperforate anus, Hirschsprung’s disease, and chronic kidney disease who developed persistent perianal and peristomal lesions due to prolonged exposure to moisture. The patient was managed with frequent diaper changes, skin aeration, and topical treatments, including zinc oxide and tacrolimus 0.03%, leading to gradual resolution over four months. This case highlights the importance of recognizing PPN and implementing appropriate preventive and therapeutic measures to ensure optimal patient care.