Anal dermatitis (overview) L30.8

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

After Eczema; After itching; Analdermatitis; Anal eczema; anogenital eczema; anogenital pruritus; Perianal dermatitis; Perianal Eczema

Definition
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Frequently occurring, polyätiological (no own entity), acute, sub-acute, chronic or chronically recurrent, usually very itchy (see also anal pruritus) dermatitis of the perianal skin, caused by irritative-toxic, infectious, constitutional or allergic mechanisms.

Etiopathogenesis
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Apocrine and eccrine sweat glands in the intertriginous space of the perianal region lead to a humid environment that offers an ideal terrain for irritant toxic, constitutional and contact allergic disease triggers. Aggravating factors are secretion outflows in proctological diseases, anatomical peculiarities such as funnel anus or formation of mariscs. The consequences are macerations and epithelial exfoliation. In this respect, the picture of anal eczema, regardless of its cause, is often that of a (uniform) erosive-weeping, usually torturous-itching dermatitis. In case of sensitization to local therapeutics, all kinds of care products, see below contact allergic anal dermatitis (anal eczema).

Localization
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Perianal region.

Diagnosis
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In the causal clarification of allergic contact eczema, a search must be made for potential allergens in basics, preservatives or active ingredients in external preparations (ointments, suppositories). Intimate sprays, powders, condoms, dyed toilet paper, detergents and disinfectants can also cause contact sensitization. It is important to exclude hemorrhoidal disease, inverse psoriasis and atopic diathesis (see differential diagnosis below).

General therapy
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  • Rehabilitation of the proctological basic or concomitant disease. Avoidance of irritants and potential allergens. Soap-free cleaning of the anus with clear water. Application of local anti-inflammatory agents on the basis of lotions and pastes containing zinc.
  • In case of weeping anal eczema, short-term use of ointments containing hydrocortisone(Vaseline has proven to be a good basis, as it has only a low irritant potential). A steroid-free alternative would be Lotio alba.
  • If necessary, sitz baths with synthetic tanning agents (e.g. Tannosynt and Tannolact) or with disinfectants (e.g. potassium permanganate: dissolve a few crystals in lukewarm water to produce a strong pink-coloured solution).

Diet/life habits
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  • Dietetically it is recommended to avoid alcohol and spicy food.
  • Soap washings should be avoided.
  • The perianal area can be cleaned with clear water (preferably using a bidet) or with vegetable oils (e.g. olive oil) applied with soft paper towels.

Literature
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  1. Proske S et al (2004) Anal eczema and its benign simulators. dermatologist 55: 259-264
  2. Rajalakshmi R et al (2011) Lichen simplex chronicus of anogenital region: a clinico-etiological study. Indian J Dermatol Venereol Leprol 77:28-36
  3. White hair E (2015) Genitoanal pruritus. dermatologist 66:53-59

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020