German S1 guidelines for the diagnosis and treatment of perianal dermatitis (anal eczema)

Abstract

Summary Perianal dermatitis (anal eczema, perianal eczema) is one of the most common proctological conditions. It may occur as a sequela or a presenting symptom of various proctological, dermatological, allergic or pathogen‐induced disorders. The three main types of anal eczema are irritant‐toxic, atopic and allergic contact dermatitis. Adequate and successful treatment requires a comprehensive diagnostic workup to determine disease etiology and includes treatment/elimination of causative factors as well as nonpharmacological interventions (avoidance of aggravating factors). In addition, adjuvant topical anti‐inflammatory and/or specific symptomatic treatment may be required. The present guidelines contain recommendations for the diagnostic and therapeutic management of perianal dermatitis. Target users of these guidelines are clinicians in the fields of dermatology and proctology, as well as all other specialties involved in the management of patients with perianal dermatitis, both in hospital and office‐based settings.

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“…The purpose of therapy for perianal eczema is to improve patient's clinical symptoms and reduce the impact on patient's life quality [ 21 ]. This investigation comprehensively assessed the clinical efficacy of Chinese angelica decoction joint tacrolimus ointment + 3% boric acid lotion on chronic perianal eczema patient's clinical symptom-related indexes, life quality index score, expression changes of immune reaction-related protein level, and overall efficacy.…”

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S1‐Leitlinie Kontaktekzem

“…Bei chronischen Kontaktekzemen mit Lichenifikation und Hyperkeratose ist die Therapie mit den potentesten Glukokortikoiden aufgrund ihrer antiproliferativen Wirkung und der vermuteten geringeren Penetration indiziert [4]. In intertriginösen Hautarealen sowie im Gesichts-und Anogenitalbereich sollten niedrigpotente Glukokortikoide verwendet werden [5]. Die Langzeitanwendung hochpotenter topischer Glukokortikoide sollte nicht nur aufgrund ihrer lokalen Nebenwirkungen begrenzt sein [113], sondern auch wegen möglicher Folgen ihrer Resorption wie zum Beispiel Osteoporose [115,116].…”