Anal itching or pruritus ani
Intractable itching around the anus may occur at any age but commonly in adult, more in men than women and more common in summer than winter and is not in itself a specific clinical entity or disease.
The causes are very numerous and includes:
· Poor hygiene due to lack of cleanliness.
· Mucous soiling due to leukorrhoea or anorectal lesion.
· Parasitic infections such as thread worms, scabies etc.
· Dermatological diseases e.g. Psoriasis
· Fungal infections e.g. Candidiasis
· Bacterial infections secondary due to scratching.
· Systemic diseases e.g. DM, liver diseases etc.
· Anal diseases e.g. Fistula in ano, sinus etc.
· Dietary e.g. Excessive consumption of alcohol etc
Careful History: Duration, time, pattern of itching and relation to defecation, bathing, ingestion of food and intake of drugs etc.
Local Examination: The perineal skin inspected for erythema, fissuring, fungal infections at the presence of thread worm and rectal examination is carried out to look for underlying associated lesion.
General Examination: Is performed to search for manifestations of allergy or skin diseases elsewhere in the body.
Laboratory Investigations: Urine, stool, to exclude diabetes and parasites. Direct microscopic and culture of scraping may reveal yeast, fungi or parasites.
Local Secondary infections
Signs associated with loss of sleep
Persistent severe discomfort
Any detectable cause is specifically treated and the following measures are employed particularly when no obvious cause detected.
Maintenance of proper Hygiene
Regular Bowel movement
Dermatological & psychiatric consultation