Perianal Contact Eczema – an Unusual Presentation of Dermatitis Artefacta

Abstract

Dermatological diseases of the perianal region may be due to systemic disorders, atopic dermatitis, lichen simplex chronicus, psoriasis vulgaris, seborrheic dermatitis, lichen sclerosus, allergic or irritant contact dermatitis and bacterial, fungal, parasitic or viral infections. Candidiasis, oxyuriasis, psoriasis and inflammatory bowel disease seem to be the most important diagnoses in clinical practice. Perianal eczema is fairly common, but there are only few studies elucidating the causal epidemiologic factors, namely the identification of relevant contact allergens. Reports of perianal contact dermatitis are not frequent, but even more uncommon is the reference to self-perpetuation of the skin lesions. The authors describe the case of a male, middle-aged bus driver, with perianal and buttock eczema caused by contact allergy to anesthetics and fragrances, that we believe, was intentionally perpetuated by continued use of anti-hemorrhoidal ointments.

The Importance of Psychosomatic Knowledge for the Treatment Approach in Dermatology

“…An inventory may present a useful instrument to screen the patient's way of understanding his or her own disease and treatment. A case report [Cunha et al, 2003] describes the diagnostic process in a patient with perianal dermatitis and its problems due to the non-compliance of the patient. The dermatological treatment was not continued which may partly be explained by the depression that was diagnosed.…”