Pruritus ani
Background
Causes
- Anorectal disease
- Poor hygiene
- Local infection
- Local irritants
- Dermatologic conditions
- Systemic illness
- Psychogenic factors
Associations
Clinical Features
- Skin appears normal with early, mild cases
- Acute, severe exacerbations associated with reddened, edematous, excoriated, skin
Differential Diagnosis
Anorectal Disorders
- Anal fissure
- Anal fistula
- Anal malignancy
- Anal tags
- Anorectal abscess
- Coccydynia
- Colorectal malignancy
- Condyloma acuminata
- Constipation
- Crohn's disease
- Cryptitis
- GC/Chlamydia
- Fecal impaction
- Hemorrhoids
- Levator ani syndrome
- Pedunculated polyp
- Pilonidal cyst
- Proctalgia fugax
- Proctitis
- Pruritus ani
- Enterobius (pinworms)
- Rectal foreign body
- Rectal prolapse
- Syphilitic fissure
Non-GI Look-a-Likes
Management
- Treat underlying cause
- To avoid scratching at night patient can wear gloves at bedtime
- Sitz baths 15min TID
- Zinc oxide can provide protective covering for the skin and may enhance healing