-IBIS-1.5.0-
tx
digestive system
pruritus ani
diagnoses

definition and etiology

definition: anal and perianal itching

etiology: there are many contributing factors in pruritus ani:
• dermatologic disorders: e.g. psoriasis
micro-organisms: e.g. candida
• parasites: e.g. pinworms
• allergic reactions: e.g. contact dermatitis
• oral antibiotic therapy: esp. tetracyclines
• hygiene: either too little or too much.
• psychogenic response: anxiety-causing-itch-causing-anxiety
• warmth and hyperhidrosis: e.g. obesity, tight underwear
• diseases: systemic (e.g. diabetes) proctologic (e.g. draining fistula), neoplasm

signs and symptoms

• the skin may be normal or show signs reflecting the underlying cause
• excoriations may be present.
• secondary infections may be present

lab findings:
• check for pinworms (Scotch tape prep)
• culture if indicated
• food sensitivity testing
• other tests to rule out possible underlying pathology

course and prognosis

Pruritus ani usually clears up quickly if the cause is analyzed and treated. The type of treatment will vary accordingly. Conventional physicians sometimes suggest avoiding spicy foods and citrus fruits, esp. grapefruit, which may aggravate the condition, but are not viewed as causative. Other physicians and health care providers may suggest specific dietary changes in accordance with the results of food sensitivity testing. Appropriate antibiotics may be required for pinworm infections, which are a common cause of this condition.

differential diagnosis

• differentiate underlying conditions


footnotes