BISACODYL INDUCED CHROMHIDROSIS- A CASE REPORT

Abstract

Abstract : Chromhidrosis is secretion of colored sweat.
Eccrine chromhidrosis is very rare and occur with ingestion of
certain drugs and dyes. We present a case of eccrine
chromhidrosis due to tartrazine coated drug - Bisacodyl
(Dulcolax). A 58 years old male presented to our skin
department with 6 months history of yellow staining of his
clothes on back side. He gave history of daily intake of
Bisacodyl for 6 months. He denied other contacts with yellow
products on cloth. Detailed clinical evaluation was done.
Routine investigations including urine sample analysis,
Wood's lamp fluorescence of skin, stained cloth and skin
biopsy was done. Pathology and differential diagnosis were
discussed. Based on history and clinical evaluation diagnosis
of eccrine chromhidrosis due to the drug Bisacodyl was
made. Proper correlation of disease entity with the drug was
made by observing the disappearance of yellow staining of
clothes after drug stoppage. This was further confirmed by
high performance liquid chromatographic analysis of the
sample collected by extraction from stained cloth. An eccrine
route of excretion of water soluble dyes can produce
chromhidrosis. Tartrazine coated in Bisacodyl, is a pyrazole
aniline dye, mainly excreted in urine. Being water soluble, it
can excrete in sweat resulting in chromhidrosis, not described
in any literature. This case is presented here to emphasize
the uncommon cause of eccrine chromhidrosis due to a
common drug Bisacodyl (Dulcolax) and also for its rarity.
Keyword :Bisacodyl, Tartrazine, Chromhidrosis.