Diagnosis and treatment of perianal dermatitis

Abstract

Perianal dermatitis is one of the most common proctological disorders. The anatomy of the anal region provides suitable conditions for the development of dermatitis. In the diagnostic work-up and the management of patients with perianal dermatitis, three types need to be distinguished: irritant contact dermatitis, atopic dermatitis, and allergic contact dermatitis. Each type has its aetiological and pathogenetic factors, which will provide clues to the diagnosis and subsequent management of the condition. In the differential diagnosis of the condition, consideration should be given to inflammatory diseases of the perianal region which may produce eczema-like patterns.

German S1 guidelines for the diagnosis and treatment of perianal dermatitis (anal eczema)

“…The particular anatomical characteristics of the anal region favor the development of dermatitis [1]: In the anal cleft, secretions from eccrine and apocrine sweat glands create a moist microclimate, which is enhanced by the retention of moisture caused by the hair in this region. This situation may be further aggravated by anal or perianal discharge associated with various proctological disorders.…”

“…It may occur as a sequela or a presenting symptom of various proctological, dermatological, allergic or pathogen‐induced disorders. The three main types are irritant‐toxic, atopic and allergic contact dermatitis , . In some cases, clinically relevant symptoms are caused by the interaction of various intrinsic and extrinsic factors (overlap phenomena).…”

“…disorders. The three main types are irritant-toxic, atopic and allergic contact dermatitis [1,3], 4]. In some cases, clinically relevant symptoms are caused by the interaction of various intrinsic and extrinsic factors (overlap phenomena).…”

S1‐Leitlinie Diagnostik und Therapie des Analekzems

“…Es tritt als Folgeerscheinung oder Teilsymptom verschiedener proktologischer, dermatologischer, allergologischer oder mikrobieller Veränderungen auf. Die drei Hauptformen des Analekzems sind das irritativ‐toxische, das atopische und das kontaktallergische Analekzem . Gelegentlich kommt es durch das Zusammenwirken verschiedener intrinsischer und extrinsischer Faktoren (Überlappungsphänomene) zu einer klinisch relevanten Symptomatik.…”

“…Es werden drei Hauptformen des Analekzems unterschieden, die jeweils mit bestimmten ätiologischen und pathogenetischen Faktoren vergesellschaftet sind –. Es handelt sich dabei um das irritativ‐toxische, das atopische und das kontaktallergische Analekzem.…”