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Pruritus Ani

Marie L. Borum, MD, EdD, MPH, MACP, FACG, AGAF and Scott Baumgartner, MPAS Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Intense anal/perianal itching and/or burning

  • Usually acute

  • Classified as primary (idiopathic)) or secondary (25–75% of cases) to anorectal pathology (1)

EPIDEMIOLOGY

Incidence

  • 1–5% of the...

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 chemical and mechanical irritants and wear proper undergarments (1).

  • High-fiber diet and/or bowel regimen to maintain regular bowel movemen...

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.
2
Davies D, Bailey J. Diagnosis and management of anorectal disorders in the primary care setting. Prim Care.  20...

ADDITIONAL READING

  • Misery L. Itch in special skin locations management. Curr Probl Dermatol.  2016;50:111–115.

  • Schubert MC, Sridhar S, Schade RR, et al. What every gastroenterologist needs to know...

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. It is a skin irritation with itch–scratch–itch cycle.

  • Conservative treatment with perianal hygiene and reassurance...

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