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General Medicine

Pruritus Ani

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Intense anal/perianal itching and/or burning

  • Usually acute

  • Classified as idiopathic (primary) or secondary (~75% of cases) to anorectal pathology (1)

EPIDEMIOLOGY

Incidence

  • Uncommon, 1–5%...

DIAGNOSIS

HISTORY

  • Patient presents with complaint of anal and/or perianal itching, burning, or excoriation.

  • Inquire about:

    • Timing (when it started, when it is worse)

    • Frequency of cleansing and products ...

TREATMENT

GENERAL MEASURES

  • Proper anal hygiene. Avoid chemical and mechanical irritants and wear proper undergarments (1).

  • High-fiber diet and/or bowel regimen to maintain regular bowel movements (1)

  • Avo...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

See patient every 2 weeks if not improving. Ensure proper hygiene, and avoidance of irritants. Work up for systemic disease, and check for persistent lichenificat...

REFERENCES

1
Ansari P. Pruritus ani. Clin Colon Rectal Surg.  2016;29(1):38–42. [View Abstract on OvidMedline]
2
Abramowitz L, Benabderrahmane M, Pospait D, et al. The prevalence of proctological s...

ADDITIONAL READING

  • Misery L. Itch in special skin locations management. Curr Probl Dermatol.  2016;50:111–115. [View Abstract on OvidMedline]

  • Schubert MC, Sridhar S, Schade RR, et al. What every ...

SEE ALSO

Pinworms; Pruritus Vulvae 

CODES

ICD10

L29.0 Pruritus ani 

ICD9

698.0 Pruritus ani 

SNOMED

90446007 Pruritus ani (disorder) 

CLINICAL PEARLS

  • Pruritus ani is characterized by intense anal/perianal itching and/or burning.

  • Skin irritation with itch–scratch–itch cycle

  • Conservative treatment with perianal hygiene and reassurance i...

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Related Images
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FIGURE 28.49. Pinworm egg from urine of 11-year-old girl. One side of the long axis is always more curved than the other.
FIGURE 28.49. Pinworm egg from urine of 11-year-old girl. One side of the long axis is always more curved than the other.
FIG. 32.3. Vulval granuloma inguinale of relatively recent origin. Some lesions are separate, others confluent. The margin of lesion is raised and scrolled; the base is granular and covered imperfectly by thin, gray slough. (From Demis DJ, Crounse RG, Dobson RL, et al, eds. Clinical dermatology, Vol 3. Hagerstown, MD: Harper & Row, 1972, with permission.)
FIG. 32.3. Vulval granuloma inguinale of relatively recent origin. Some lesions are separate, others confluent. The margin of lesion is rai...
Figure 32.11. Three female worms of E. vermicularis are seen in a cellophane tape preparation.
Figure 32.11. Three female worms of E. vermicularis are seen in a cellophane tape preparation.
Pinworms - Main image shows young child scratch the anal region, an indication of pinworm (enterobius vermicularis) infestion; insert shows pinworms as seen under a microscope.
Pinworms - Main image shows young child scratch the anal region, an indication of pinworm (enterobius vermicularis) infestion; insert shows...
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