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General Medicine

Pruritus Ani

Anna L. Silverman, MD, Vivian Lee, MD and Marie L. Borum, MD, EdD, MPH, MACP, FACG, AGAF Reviewed 06/2019
 


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

  • 1–5% of the ge...

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 us...

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 lichenificati...

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 sy...

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 g...

CODES

ICD10

L29.0 Pruritus ani 

ICD9

698.0 Pruritus ani 

SNOMED

90446007 Pruritus ani (disorder) 

CLINICAL PEARLS

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

  • Skin irritation with itch–scratch–itch cycle

  • Conservative treatment with perianal hygiene and reassurance is succes...

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