Pruritus Ani

Published on 06/06/2015 by admin

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Last modified 06/06/2015

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Chapter 42 Pruritus Ani

INTRODUCTION

Description: Pruritus ani is acute or chronic itching (generally intense) of the anal and perianal skin. Patients also may have complaints of vulvar itching or of a vaginal infection that has not responded to therapy.

Prevalence: Common.

Predominant Age: All ages.

Genetics: No genetic pattern.

ETIOLOGY AND PATHOGENESIS

Causes: Anal disease—fissures, fistulae, infection (bacterial, fungal, pinworms, scabies), neoplasia, hemorrhoids, leakage of stool. Dermatologic processes—psoriasis, eczema, fecal irritation, contact dermatitis, seborrheic dermatitis, vulvitis, chemical dermatitis (diarrheal irritation), dietary intolerance (coffee, cola, tomatoes, chocolate). Other—excessively zealous hygiene, psychologic problems.

Risk Factors: Hemorrhoids, obesity.

CLINICAL CHARACTERISTICS

Signs and Symptoms

• Anal and perianal itching

• Perianal erythema

• Anal fissures

• Excoriation

• Bleeding after bowel movement

DIAGNOSTIC APPROACH

Differential Diagnosis

• Pruritus vulvae

• Contact dermatitis

• Bacterial or fungal infection

• Parasites (pinworms, scabies)

• Diabetes mellitus

• Liver disease

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