Pruritus Ani

by Nick
(Cincinnati, OH (USA))

I'm a 33-year-old male and have had a generally clean bill for most of my life with no medical conditions to note. Two years ago, I began to notice an anal irritation. I had never had any problems in the anal area before this. It would itch from time to time and seemed to be very sporadic. When it flares up badly for a four to five day stretch, the itch becomes very intense. Some days were worse than others without any known reason. Over the past two years, I have days where it's very mild to almost nonexistent. Other days it consumes my mind and causes major grief. After seeing my general doctor, he diagnosed it as pruritus ani. He prescribed Ketoconasole cream and recommended I apply it twice daily for 14 days. That seemed to help for awhile, but the problem always comes back later again to cause me grief. For the record, I use soft unscented toilet paper, wash the area with water only, keep the area as dry as possible, and generally have excellent hygiene. Just recently, it flared up to one of the worst levels ever and I had my wife takes pictures to share with anyone in the medical community. Hopefully you can help make some recommendations or diagnosis.

Thank you!

Pruritis Ani

The picture clearly shows you have been scratching the area a lot. Pruritis ani can be very itchy and scratching it only makes things worse. If you stop scratching (yes I know its difficult!) it may well settle down as you get in to a cycle of scratching.

The area does look a little violaceous which makes me wonder if you have some lichen planus here. Applying hydrocortisone cream may help with the symptoms of itch too.




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