John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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Adult anal pruritus: Causes and management Volume 28, issue 10, Décembre 2021

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Authors
Groupe Hospitalier Paris Saint-Joseph, Service de proctologie médico-chirurgicale, 185 rue Raymond Losserand, 75014 Paris
* Correspondance

Anal pruritus is a common condition that can significantly impair patients’ quality of life. Its management is complex due to a wide range of etiologies. However, primary (essential or idiopathic) anal pruritus is the most common cause. This diagnosis is made in the absence of an obvious secondary cause. Its management is essentially based on hygienic and dietary measures associated with topical treatments aimed at drying and protecting the skin, but also at breaking the vicious circle of anal pruritus with dermocorticoids. Secondary causes are multiple, dominated by infectious pathologies which can be suspected from the outset in the case of a generally recent evolution, an evocative clinical aspect and, if necessary, on positive local samples. This being said, a trial antiparasitic treatment may be prescribed from the outset. Dermatological pathologies are also frequent and dominated by inverted psoriasis but also contact eczema or lichen planus or sclerosus. Their diagnosis is based on anamnesis and, if necessary, histological analysis. Finally, a histological sample is also indicated in the event of failure of first-line treatments and/or in the event of recurrent evolution in order not to ignore a tumoral affection such as Bowen's disease (High Grade Squamous Intraepithelial Lesion) or Paget's disease, which require a specific management