Pruritus ani: common infection and treatment

ABSTRACT

Pruritus ani is a manifestation of a wide spectrum of disease conditions. Infections form a minor aetiological fraction but include organisms from the various microbiological subdisciplines. Fungal causes of pruritus ani usually come from the normal flora, and can be diagnosed in the office, by microscopy using a mixture of potassium hydroxide and dimethyl sulfoxide. Parasites causing pruritus ani may be transmitted by direct contact, the faeco-oral or sexually. Treatment of scabies and enterobiasis should involve simultaneous treatment of family members. Articles of clothing and bed sheets must be exposed to heat. Lindane (gamma benzene hexachloride) should not be used in pregnant women and children under the age of two years to avoid potential neurotoxicity. Irrespective of the aetiology, severe pruritus ani predisposes to secondary bacterial infection (AU)