Cholestyramine Ointment Used on an Infant for Severe Buttocks Rash Resistant to Standard Therapeutic Modalities

Abstract

Objective: To describe a case of severe buttocks rash refractory to standard therapy that was treated successfully with cholestyramine 5% in Aquaphor. Case Summary: An infant developed a rash that worsened to a severe and very painful buttocks rash refractory to other therapies. When cholestyramine ointment was applied after every stooling, the rash was markedly improved within 2 days and completely resolved 7 days after therapy was initiated. Discussion: Fecal expulsion of bile acids may be the reason for treatment-refractory severe buttocks rashes in infants. The use of topical cholestyramine ointment may lead to the resolution of problems even among previously determined treatment-refractory cases. This was shown elsewhere in a child on a promotility drug. Conclusions: Cholestyramine ointment can be compounded and may provide benefit for infants who have a severe buttocks rash that is refractory to traditional therapies.