BISACODYL INDUCED CHROMHIDROSIS- A CASE REPORT

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.