Alternative Treatment for Refractory Jacquet Dermatitis After Hirschsprung Disease Surgery: a Case Report

Abstract

Introduction: Jacquet's erosive diaper dermatitis (JDD) is a severe form of diaper dermatitis, characterized by papuloerythematous erosions with crater-like borders in the genital and perianal regions. Case presentation: A 2-year-old male patient was diagnosed with Hirschsprung disease (HD) during the neonatal period. A transition zone was detected in the rectosigmoid region on a contrast enema. Full-thickness rectal biopsy confirmed aganglionosis, and a colostomy was created from the transverse colon. At 18 months of age, the patient underwent the Swenson procedure, and the colostomy was closed during the same session. Following the operation, spontaneous stool passage was achieved. Approximately six months after surgery, ulcerative lesions characteristic of Jacquet dermatitis developed in the perianal region. Despite six months of treatment with moisturizers, regenerative, epithelializing, and barrier therapies (e.g., zinc oxide, madecassoside, shea butter, glycerin, oatmeal, hyaluronic acid), the lesions did not improve. However, after initiating treatment with pure Aloe Vera gel, including a 10 % diluted natural extract applied four times daily, plus a dairy-free diet for three weeks, a rapid clinical response was observed, with visible improvement within the same period. Conclusion: The combination of Aloe Vera-based ointment plus dairy-free diet seems to be an effective management strategy for children with post pull-through Jacquet's dermatitis.