Pruritus ani

Background

Causes

• Anorectal disease
• Poor hygiene
• Local infection
  • Pinworms, strep
• Local irritants
• Dermatologic conditions
• Systemic illness
• Psychogenic factors

Associations

• Anal Fissure
• Anal Fistula
• Hemorrhoids
• Rectal Prolapse

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
  • Internal hemorrhoid
  • External hemorrhoid
• 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

• Prostatitis

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

See Also

• Anorectal Disorders