Can proctological procedures resolve perianal pruritus and mycosis?

Abstract

Twenty-three patients with pruritus ani associated with anal mycosis underwent primary treatment of a concurrent anal disorder. The anal disorders included haemorrhoids (n = 9), fissure (n = 8), anal spasm without fissure (n = 5), and occult mucosal prolapse (n = 1). Pretreatment investigation of faeces for parasites was negative. The glucosal tolerance test and white blood cell count were normal in all cases. Culture of skin smears from the perianal region was positive for Candida only in 16 patients, Dermatophytes only in 6 and a combination of both in 1 patient. Following the appropriate proctological procedure, pruritus resolved or markedly improved in 20 patients. The remaining three patients required antifungal treatment with econazole. Two of these, however, continued to complain of pruritus. It is suggested that in patients with pruritus ani associated with perianal mycosis, antimycotic therapy should be used only if fungal infection persists after treatment of the underlying proctological disease.

Mycotic and Bacterial Infections

“…In these cases, anal mycosis may resolve after treatment of the underlying proctologic disease. 5 Fungal cultures can help specify the type of mycotic infection and help differentiate it from other infectious etiologies. The culture is obtained from scrapings of the scaly portions of the lesion and performed on Sabouraud glucose agar.…”

A Review of the Therapeutic Interventions in the Management of Pruritus Ani

“…It is recommended to treat of all co-existing a norectal conditions [13,14] . Pironeet al suggested that surgery for benign anorectal conditions can eliminate perianal fungal infection and both measures together reduce pruritus [16] .…”

Persistent Perianal Dermatitis Associated with Mucosal Hemorrhoidal Prolapse

“…Thus, any variations in the anal anatomy that produce soiling can be responsible for perianal dermatitis. 3 Grade III and grade IV hemorrhoids and anal tags, polyps, fissures, and fistulas are causes of overt soiling and are evident upon dermatologic examination. 4 Contrarily, internal mucosal-hemorrhoidal prolapse, another cause of occult soiling, stays in the anal canal and cannot be seen through external inspection; it can be diagnosed only with a complete proctologic examination, which includes proctoscopy.…”