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Pruritus Ani

Marie L Borum, MD, EdD, MPH and Faraz A Sohail, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Intense anal/perianal itching and/or burning

  • Usually acute (defined as <6 weeks of symptoms)

  • Classified as primary (idiopathic) or secondary (25-75% of cases) to anorectal pathology...

DIAGNOSIS

HISTORY

  • Patients present with complaints of anal and/or perianal itching, burning, or excoriation.

  • Inquire about:

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

    • Perianal hygiene (frequency of cleans...

TREATMENT

GENERAL MEASURES

  • Proper anal/perianal hygiene. Avoid vigorous rubbing while cleansing after bowel movement. Use cotton swabs moistened with warm water instead of tissue paper. Avoid chemical ...

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 lichenification...

REFERENCES

1
Siddiqi S, Vijay V, Ward M, Mahendran R, Warren S. Pruritus ani. Ann R Coll Surg Engl. 2008;90(6):457-463.
2
Swamiappan M. Anogenital Pruritus - An Overview. J Clin Diagn Res. 2016;10(4):WE0...

ADDITIONAL READING

  • Davies D, Bailey J. Diagnosis and Management of Anorectal Disorders in the Primary Care Setting. Prim Care. 2017 Dec;44(4):709-720.

  • ...

SEE ALSO

Pinworms; Pruritus Vulvae 

CODES

ICD10

L29.0 Pruritus ani 

SNOMED

90446007 Pruritus ani (disorder) 

CLINICAL PEARLS

  • Pruritus ani is characterized by anal/perianal itching and/or burning. It is a skin irritation with itch–scratch–itch cycle.

  • Conservative treatment with perianal hygiene and reassurance...

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