Pensando en la dermatitis perianal

Osés, I. García; Fernández, Javier Martín; Garcia, Celi; Alonso, Javier Martín

doi:10.4321/s1139-76322015000100012

Cited by 2 publications

(9 citation statements)

References 6 publications

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“…However, the main reason for this unknown incidence is considered the fact that PID remains too often unrecognized by healthcare professionals. PID appears all over the world and has been reported by authors in various countries from different continents, including the United States[2,4,5,23,25,26,28,32,38,43,46,57,59,61-63], Canada[3,20,40], Australia[11,33], Africa (Egypt[15]), Europe (United Kingdom[7,10,29,30,65], Spain[6,19,21,31,42,64], Italy[22,35,39,47,48], The Netherlands[36,60], Finland[37], Sweden[41,50], Germany[8,9,45], Denmark[27], Switzerland[12,17,54], France[13,16,55], Greece[58]), Asia (India[44], Taiwan[49], Japan[51,52], Iran[56]), Israel[14,18] and Turkey[53]. It appears that no cases have been published from Eastern Europe.…”

Section: Epidemiologymentioning

confidence: 99%

“…Boys have been initially described as predominantly affected by PID, representing about or more than 70%-80% of cases[2,4,8,10,15,18,20,21,28] (Table 1). Also, most case reports have presented male patients (Table 3).…”

Section: Epidemiologymentioning

confidence: 99%

“…Symptoms like anal pruritus (itching), painful defecation with consequent retentive constipation, anal pain, mucous (sometimes purulent)[12,14] and/or bloody anal discharge (blood-streaked stools) are usually present[2,4-8,10,28,43,59]. Very rarely, abdominal pain (related to defecation or to retention to defecation)[21]), fecal incontinence[2,21,30] or tenesmus[21,22] could be associated. Exceptionally, other symptoms have been reported, including fever[21,44], irritability[18], diarrhea[15,36] and muscular pain[38].…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Very rarely, abdominal pain (related to defecation or to retention to defecation)[21]), fecal incontinence[2,21,30] or tenesmus[21,22] could be associated. Exceptionally, other symptoms have been reported, including fever[21,44], irritability[18], diarrhea[15,36] and muscular pain[38]. Synthetizing data from the literature (Tables 1 and 3), the following frequencies of symptoms and signs are detected: perianal itching (78%-100%); painful defecation (50%); constipation (47%-58%); blood-streaked stools (21%-60%); purulent secretion (27%); anal fissures (26%-40%); perianal pain (20%); and, mucous discharge at the anal margin (10%)[4-8,10,11,14,17,20,21].…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Infection can extend to genital organs, resulting in vulvo-vaginitis[2,3,5,6,13,16,21-23,43,47,50,57,65] or balanitis[3,22,23,29,33,42,45,50,64], and cultures from these areas grow same type of bacteria[2,22,29]. Small papules or pustules on the buttocks are suggestive for S. aureus [26,32].…”

Section: Clinical Presentationmentioning

confidence: 99%

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Perianal infectious dermatitis: An underdiagnosed, unremitting and stubborn condition

Serban

2018

WJCP

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Perianal infectious dermatitis (PID) represents a superficial inflammation of the perianal skin, which is of bacterial origin (classically, group A beta-hemolytic streptococci). This narrative review aims to critically review and summarize the available scientific literature regarding pediatric PID, being the first of its kind, to the best of the author’s knowledge. It also reports the first cases of Romanian children with PID. Multiple databases were subjected to systematic literature search (from 1966 to April 30, 2018) to identify studies and case reports of children with PID. As such, this review provides updated information about essential aspects of PID (epidemiology, etiology, pathogenesis, as well as clinical features, required investigations and therapeutic options) and of diagnostic pitfalls. Although a well-defined entity, PID remains largely underdiagnosed. PID may mimic other common conditions with skin manifestations (like candidiasis, pinworms, eczema, irritant dermatitis, anal fissure, hemorrhoids, Crohn’s disease, psoriasis, seborrheic dermatitis, zinc deficiency dermatosis and even sexual abuse), with consequent unnecessary, sometimes expensive and invasive investigations and futile therapies, which cause patients and families discomfort and distress. Since PID has an unremitting course, early recognition is imperative, as it allows for prompt and efficacious antibiotic therapy. However, PID represents a stubborn condition and, even if properly treated, its recurrence rate remains high. Further well-designed prospective randomized controlled trials, with adequate follow-up, are required in order to formulate the optimum personalized antibiotic therapy (oral alone or in association with topical medication), able to prevent recurrences. Awareness of this condition by healthcare professionals should improve patient outcomes.

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Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

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Perianal infectious dermatitis: An underdiagnosed, unremitting and stubborn condition

Serban

2018

WJCP

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Perianal streptococcal disease in childhood: systematic literature review

et al. 2021

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Group A Streptococcus has been associated with a perianal infection. We conducted a systematic review of the literature on childhood streptococcal perianitis in three databases: Excerpta Medica, National Library of Medicine, and Web of Science. The main purposes were to document the clinical features, the tendency to recur, the association with an asymptomatic streptococcal throat carriage, the accuracy of rapid streptococcal tests, and the mechanism possibly underlying the acquisition of this infection. More than 80% of cases are boys ≤7.0 years of age with defecation disorders, perianal pain, local itch, rectal bleeding, or fissure and a sharply demarcated perianal redness. Perianitis is associated with a streptococcal tonsillopharyngitis in about every fifth case. The time to diagnosis is ≥3 weeks in 65% of cases. Recurrences occur within 3½ months in about 20% of cases. An asymptomatic group A streptococcal throat carriage occurs in 63% of cases. As compared with perianal Streptococcus A culture, the rapid streptococcal tests have a positive predictive value of 80% and a negative predictive value of 96%. It is hypothesized that digital inoculation from nasopharynx to anus underlies perianitis. Many cases are likely caused directly by children, who are throat and nasal carriers of Streptococcus A. Some cases might occur in children, who have their bottoms wiped by caregivers with streptococcal tonsillopharyngitis or carriage of Streptococcus.Conclusion: Perianitis is an infection with a distinctive presentation and a rather long time to diagnosis. There is a need for a wider awareness of this condition among healthcare professionals. What is Known:• Group A Streptococcus may cause perianitis in childhood.• Systemic antimicrobials (penicillin V, amoxycillin, or cefuroxime) are superior to topical treatment. What is New:• The clinical presentation is distinctive (defecation disorders, perianal pain, local itch, rectal bleeding, or fissure and a sharply demarcated perianal redness).• The time to diagnosis is usually ≥3 weeks.Recurrences occur in about 20% of cases.

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Pensando en la dermatitis perianal

Cited by 2 publications

References 6 publications

Perianal infectious dermatitis: An underdiagnosed, unremitting and stubborn condition

Perianal infectious dermatitis: An underdiagnosed, unremitting and stubborn condition

Perianal streptococcal disease in childhood: systematic literature review

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