Causes
|
Signs and symptoms
|
Diagnostic approach
|
Treatment
|
Anorectal
Disorders
|
Inflammatory bowel disease
|
- Abdominal pain
- Diarrhea (secretory, mucoid,or bloody)
- Weight loss
- Perianal pruritis
|
- Physical examination
- Antinuclear antibodies
- Sigmoidoscopy/colonoscopy
|
- Sulfasalazine, mesalamine.
- Oral steroids.
- Antibiotics (e.g, metronidiazole).
- Azathioprine, 6-mercaptopurine.
- Infliximab, adalimumab, etc.
|
Hemorrhoids(internal or external)
|
- Bright red blood on toilet paper/stool.
- Pain with defecation.
- Painful lump in the anal area.
- Perianal pruritis
|
- Physical examination
- Anoscopy/sigmoidoscopy
|
- Psyllium, methylcellulose.
- Surgery.
|
Anal fissure
|
- Bright red blood on toilet paper/stool.
- Pain with defecation.
- Perianal pruritus.
- Anal tears
|
- Physical examination reveals anal lacerations
|
- Topical anesthetics.
- Psyllium, methycellulose.
|
Skin
infections
|
Bacterial
|
- Skin edema, erythema, and warmth.
- Pruritis, pain, and discharge from the lesions.
|
- Physical examination reveals local inflammatory findings.
- Culture/sensitivity of discharge
|
- Topical or oral antibiotics.
|
Candidal
|
- Erythematous skin plaques and erosions with peripheral scaling.
- Pruritus on the skin plaques.
|
- KOH preparation of skin scrappings
|
|
Scabies
|
- Erythematous papules with hemorrhagic crustings.
- Pruritus, pain, and bleeding from papules
|
- Identification of eggs on skin scrapings.
|
- Topical permethrin.
- Oral ivermectin.
|
HPV
(Condylomata
acuminata)
|
- Soft papules/plaques in the anogenital area.
- Pruritus, pain, and bleeding from papules
|
- Physical examination.
- Shave biopsy of the lesion.
|
- Topical trichloroacetic acid.
- Topical imiquimod.
- Cryotherapy or surgical resection
|
Skin disorders
|
Atopic dermatitis
|
- Erythematous, pruritic, scaly skin lesions
|
Elevated CK, LDH, ALP, AST, and ALT
|
History of recent use of SSRIs, SNRIs , or MAOIs.
|
Seborrheic dermatitis
|
- Erythematous, yellow, oily plaques
- Mild pruritus
|
Elevated CK, LDH, ALP, AST, and ALT
|
History of recent use of SSRIs, SNRIs , or MAOIs.
|
Contact dermatitis
|
|
Elevated CK, LDH, ALP, AST, and ALT
|
History of recent use of SSRIs, SNRIs , or MAOIs.
|
Lichen planus
|
|
Elevated CK, LDH, ALP, AST, and ALT
|
History of recent use of SSRIs, SNRIs , or MAOIs.
|
Lichen sclerosis
|
|
Elevated CK, LDH, ALP, AST, and ALT
|
History of recent use of SSRIs, SNRIs , or MAOIs.
|
Perianal carcinoma (Bowen disease)
|
|
Elevated CK, LDH, ALP, AST, and ALT
|
History of recent use of SSRIs, SNRIs , or MAOIs.
|
Hygiene
Related problems
|
Excessive sweating and Poor cleaning
|
|
Elevated CK, LDH, ALP, AST, and ALT
|
History of recent use of SSRIs, SNRIs , or MAOIs.
|
Meticulous cleansing of anal area
|
|
Elevated CK, LDH, ALP, AST, and ALT
|
History of recent use of SSRIs, SNRIs , or MAOIs.
|
Skin irritants
|
|
Elevated CK, LDH, ALP, AST, and ALT
|
History of recent use of SSRIs, SNRIs , or MAOIs.
|