Perianal ergotismus gangraenosus

Ergotamine-containing drugs are widely used in the treatment of acute migraine attacks. Among others, spastic vasoconstrictions are one of the possible side effects usually affecting the lower extremities and sometimes leading to gangrene. The case of a 75 year old woman is presented who was suffering from migraine-attacks since adolescence. Due to longterm use of ergotamine containing suppositories she developed perianal ulcers. After withdrawal of the drug the ulcers healed up entirely. The spectrum of ergotamine-induced side-effects and possible intervention strategies are discussed.