Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 15-44: Other Anal Conditions + Key Features Download Section PDF Listen +++ ++ Characterized by perianal itching and discomfort May be caused by poor anal hygiene associated with Fistulas Fissures Prolapsed hemorrhoids Skin tags Minor incontinence Conversely, overzealous cleansing with soaps may contribute to local irritation or contact dermatitis + Clinical Findings Download Section PDF Listen +++ ++ In patients with idiopathic perianal pruritus, examination may reveal Erythema Excoriations Lichenified, eczematous skin + Diagnosis Download Section PDF Listen +++ ++ Following must be excluded Contact dermatitis Atopic dermatitis Bacterial infections (Staphylococcus or Streptococcus) Parasites (pinworms, scabies) Candidal infection (especially in diabetics) Sexually transmitted disease (condylomata acuminata, herpes, syphilis [condylomata lata], molluscum contagiosum) Other skin conditions (psoriasis, Paget disease, lichen sclerosis) + Treatment Download Section PDF Listen +++ ++ After bowel movements, the perianal area should be cleansed with nonscented wipes premoistened with lanolin followed by gentle drying A piece of cotton ball should be tucked next to the anal opening to absorb perspiration or fecal seepage A short course of high-potency topical corticosteroid may be tried, although efficacy has not been demonstrated Diluted capsaicin cream (0.006%) led to symptomatic relief in 75% of patients in a double-blind crossover study Anal ointments and lotions may exacerbate the condition and should be avoided