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Pruritus Ani

Pruritus ani is a symptom complex consisting of perianal discomfort and itching. It is much more common in men than women, and it is idiopathic in

Clinical Evaluation

Discomfort is exacerbated by friction or a warm, moist perineal environment. Poor anal hygiene or anus itching over-cleansing with soap is often a contributing factor. Diabetes, antibiotic use, vaginal discharge or infection, and other skin disorders should be

Patients with idiopathic pruritus often have intermittent seepage from the anal canal.

A decrease in resting anal canal pressure occurs with coffee intake, and exacerbation of itching symptoms can occur with ingestion of caffeine.

Common Conditions Causing Pruritus Ani

Anorectal Disease. Fissures, fistula-in-ano, proctitis, prolapsing hemorrhoids, skin tags, sphincter dysfunction

Infection. Candida organisms, condyloma acuminata, pinworms, scabies

Dermatologic Disorders. Contact dermatitis, lichen planus, lichen sclerosus, psoriasis, seborrhea.

Physical Exam. Mild pruritus ani manifests as mild erythema and excoriations of the perianal skin. In later stages, the skin may be raw, red, and oozing or pale and lichenified with exaggerated skin folds. Examination of the anus and rectum may reveal 

Treatment of