Materiały źródłowe

• #1 Approach to the patient with anal pruritus – UpToDate

  https://www.uptodate.com/contents/approach-to-the-patient-with-anal-pruritus

  Anal pruritus is estimated to affect 1 to 5 percent of the general population. However, most of these patients probably do not come to medical attention. Anal pruritus is more common in the fourth to sixth decades of life and has a higher prevalence in males. […] Approximately 75 percent of cases of anal pruritus are secondary to inflammatory, infectious, systemic, neoplastic, and anorectal disorders that contribute to or underlie the development of pruritus.

• #2 Evaluation, management and future perspectives of anal pruritus: a narrative review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9892672/

  Anal pruritus is defined as a condition characterized by itching around the perianal region. It affects around 15% of the general adult population, and it is four times more common in men than women. […] Although not life threatening, when long lasting this condition can greatly impair patients quality of life and even result in psychological issues. […] There are up to 100 conditions leading to perianal itching, which makes differential diagnostics and treatment quite challenging. […] In view of that, a thorough history and digital examination is of great importance. […] Infectious etiologies are quite often diagnosed in patients with anal pruritus, thus microbiological investigation should be considered in a high-risk patient. […] Although not widely used in clinical practice, several additional classification systems have been proposed by various authors.

• #3 Pruritus Ani | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116496/all/Pruritus_Ani?q=Burns

  15% of the general population […] Affects 15% of the population.

• #4 Anal itching | The BMJ

  https://www.bmj.com/content/355/bmj.i4931

  Itching in the perianal area pruritus ani causes discomfort with an uncontrollable desire to scratch. […] Data on prevalence and aetiology are scarce because most patients do not consult a doctor. […] It is estimated that 5% of the population are affected by anal itching at some point in life, more commonly men, and predominantly when they are in the fourth to sixth decade of life.

• #5 Approach to the patient with anal pruritus – UpToDate

  https://www.uptodate.com/contents/approach-to-the-patient-with-anal-pruritus

  Anal pruritus is estimated to affect 1 to 5 percent of the general population. However, most of these patients probably do not come to medical attention. Anal pruritus is more common in the fourth to sixth decades of life and has a higher prevalence in males. […] Approximately 75 percent of cases of anal pruritus are secondary to inflammatory, infectious, systemic, neoplastic, and anorectal disorders that contribute to or underlie the development of pruritus.

• #6 Evaluation, management and future perspectives of anal pruritus: a narrative review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9892672/

  Anal pruritus is defined as a condition characterized by itching around the perianal region. It affects around 15% of the general adult population, and it is four times more common in men than women. […] Although not life threatening, when long lasting this condition can greatly impair patients quality of life and even result in psychological issues. […] There are up to 100 conditions leading to perianal itching, which makes differential diagnostics and treatment quite challenging. […] In view of that, a thorough history and digital examination is of great importance. […] Infectious etiologies are quite often diagnosed in patients with anal pruritus, thus microbiological investigation should be considered in a high-risk patient. […] Although not widely used in clinical practice, several additional classification systems have been proposed by various authors.

• #7 Pruritus Ani: Causes and Treatment | Doctor

  https://patient.info/doctor/pruritus-ani

  Pruritus ani can be an important symptom secondary to specific disease processes. Inflammatory diseases of the skin, infections, infestations, premalignant and malignant neoplasms, and anorectal and systemic diseases may cause perianal itching. More often, there is no disease-specific aetiology and this is called idiopathic pruritus ani, which is responsible for 50-90% of cases, and affects 1-5% of the general population. […] Pruritus ani is four times more common in men than in women. It can occur at any time of life but is more common between 40-60 years of age.

• #8 Infektionskrankheiten der Haut | The itchy bottom: causes and treatment | springermedizin.at

  https://www.springermedizin.at/infektionskrankheiten-der-haut/hautpflege/the-itchy-bottom-causes-and-treatment/27197284

  Anal pruritus is a frequent disorder accounting for many proctological consultations, affecting mainly middle-aged males. […] Anal itching affects about 1 to 5% of the population, with a higher prevalence in men (4:1). […] It represents the second most common proctological complaint after haemorrhoids.

• #9 Approach to the patient with anal pruritus – UpToDate

  https://www.uptodate.com/contents/approach-to-the-patient-with-anal-pruritus/print

  Itching of the anus or perianal skin is a common disorder usually arising from benign conditions. This topic will review the etiology, diagnostic approach, and management of patients with anal pruritus. […] Anal pruritus is estimated to affect 1 to 5 percent of the general population. However, most of these patients probably do not come to medical attention. Anal pruritus is more common in the fourth to sixth decades of life and has a higher prevalence in males.

• #10 Anal Itching (Pruritus Ani): Causes, Treatment, Home Remedies

  https://my.clevelandclinic.org/health/diseases/15574-anal-itching-pruritus-ani

  Approximately 1% to 5% of the population has anal itching. Men are about four times more likely to have an itchy anus. […] Anal itching can affect anyone. However, you may be more likely to have an itchy anus if you’re between the ages of 40 and 70 and a man. […] Your healthcare provider will perform a physical examination to identify possible causes of your itchy anus, such as dermatological conditions or illnesses. They’ll visually inspect your perianal area and note any changes in skin color, skin texture, rashes or lesions. […] If your healthcare provider can’t determine the cause of your itchy anus, or if you don’t respond to treatment, they may refer you to a dermatologist.

• #11

  https://fascrs.org/patients/diseases-and-conditions/a-z/pruritis-ani-expanded-version

  Pruritis ani most commonly affects adults, affecting from 1% to 5% of people in the general population. Men are more commonly affected than women with a 4:1 ratio. The condition is most common in people age 40s to 60s. […] While this is a wide variety of potential causes, it is important to understand that in many cases the itching has no identifiable source. […] A careful medical history must be obtained from the patient focusing on the timing and duration of the pruritis ani as well as any accompanying symptoms. […] The goal of therapy is to restore clean, dry, and intact skin. Treatment can be challenging, as many cases have no clear identifiable cause. […] In order to control symptoms, a short course of a steroid ointment may be tried. […] Patients coming to the doctor for evaluation of pruritis ani with moderate to severe changes of the skin, may be treated by application of Berwicks dye (which is a combination of gentian violet and brilliant green pigment) with alcohol.

• #12 Approach to the patient with anal pruritus – UpToDate

  https://www.uptodate.com/contents/approach-to-the-patient-with-anal-pruritus

  Anal pruritus is estimated to affect 1 to 5 percent of the general population. However, most of these patients probably do not come to medical attention. Anal pruritus is more common in the fourth to sixth decades of life and has a higher prevalence in males. […] Approximately 75 percent of cases of anal pruritus are secondary to inflammatory, infectious, systemic, neoplastic, and anorectal disorders that contribute to or underlie the development of pruritus.

• #13 Evaluation, management and future perspectives of anal pruritus: a narrative review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9892672/

  Anal pruritus is defined as a condition characterized by itching around the perianal region. It affects around 15% of the general adult population, and it is four times more common in men than women. […] Although not life threatening, when long lasting this condition can greatly impair patients quality of life and even result in psychological issues. […] There are up to 100 conditions leading to perianal itching, which makes differential diagnostics and treatment quite challenging. […] In view of that, a thorough history and digital examination is of great importance. […] Infectious etiologies are quite often diagnosed in patients with anal pruritus, thus microbiological investigation should be considered in a high-risk patient. […] Although not widely used in clinical practice, several additional classification systems have been proposed by various authors.

• #14 Evaluation, management and future perspectives of anal pruritus: a narrative review | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-023-01018-5

  Anal pruritus is defined as a condition characterized by itching around the perianal region. It affects around 15% of the general adult population, and it is four times more common in men than women. […] Although, not life threatening, when long lasting this condition can greatly impair patients quality of life and even result in psychological issues. […] It is mainly categorized as either primary (idiopathic) or secondary, being a consequence of causal pathology. […] The main linking factor of the idiopathic pruritis is thought to be an increased fecal contamination of the anal region. […] Several studies showed abnormal sphincter relaxation leading to fecal soiling and perianal irritation initiating what is called an itchscratch cycle. […] In this narrative review we overview the classification, diagnostics and possible treatment options of anal pruritus.

• #15 Evaluation, management and future perspectives of anal pruritus: a narrative review | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-023-01018-5

  Anal pruritus is defined as a condition characterized by itching around the perianal region. It affects around 15% of the general adult population, and it is four times more common in men than women. […] Although, not life threatening, when long lasting this condition can greatly impair patients quality of life and even result in psychological issues. […] It is mainly categorized as either primary (idiopathic) or secondary, being a consequence of causal pathology. […] The main linking factor of the idiopathic pruritis is thought to be an increased fecal contamination of the anal region. […] Several studies showed abnormal sphincter relaxation leading to fecal soiling and perianal irritation initiating what is called an itchscratch cycle. […] In this narrative review we overview the classification, diagnostics and possible treatment options of anal pruritus.

• #16 Pruritus Ani: Causes and Treatment | Doctor

  https://patient.info/doctor/pruritus-ani

  Pruritus ani can be an important symptom secondary to specific disease processes. Inflammatory diseases of the skin, infections, infestations, premalignant and malignant neoplasms, and anorectal and systemic diseases may cause perianal itching. More often, there is no disease-specific aetiology and this is called idiopathic pruritus ani, which is responsible for 50-90% of cases, and affects 1-5% of the general population. […] Pruritus ani is four times more common in men than in women. It can occur at any time of life but is more common between 40-60 years of age.

• #17 Evaluation, management and future perspectives of anal pruritus: a narrative review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9892672/

  Anal pruritus is defined as a condition characterized by itching around the perianal region. It affects around 15% of the general adult population, and it is four times more common in men than women. […] Although not life threatening, when long lasting this condition can greatly impair patients quality of life and even result in psychological issues. […] There are up to 100 conditions leading to perianal itching, which makes differential diagnostics and treatment quite challenging. […] In view of that, a thorough history and digital examination is of great importance. […] Infectious etiologies are quite often diagnosed in patients with anal pruritus, thus microbiological investigation should be considered in a high-risk patient. […] Although not widely used in clinical practice, several additional classification systems have been proposed by various authors.

• #18 Evaluation, management and future perspectives of anal pruritus: a narrative review | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-023-01018-5

  Infectious etiologies are quite often diagnosed in patients with anal pruritus, thus microbiological investigation should be considered in a high-risk patient. […] Although not widely used in clinical practice, several additional classification systems have been proposed by various authors. […] Management of patients with anal pruritus may be challenging and long lasting. […] For instance, the infectious pruritus causes should be treated with antiviral, antibiotic, antifungal or anthelminthic medicine, according to the detected microorganisms. […] Similarly, when a proctological disease such as hemorrhoids, anal fistula or fissure are suspected to be the underlying cause of pruritus, the treatment of these conditions usually, but not always, bring relief from pruritus symptoms. […] In long lasting intractable idiopathic pruritus cases, intradermal methylene blue injections may be used as a solution. […] Although initial results of these novel treatment agents are promising, further research is warranted to determine their safety and effectiveness for treating idiopathic anal pruritus.

• #19 13 Reasons Your Butthole Itches and How to Get Quick Relief

  https://www.businessinsider.com/guides/health/conditions-symptoms/why-does-my-butthole-itch

  Sexually transmitted infections that can lead to perianal itching include gonorrhea, herpes, HPV, and chlamydia. […] Pinworm infections are the most common intestinal-worm infection in the United States. […] Anal cancer occurs when malignant cells form in the tissue around the anus. Many cases of anal cancer are caused after contracting human papillomavirus (HPV). […] Anal itching is more common than you might think, and „while anal itching may sound like a trivial reason to see a doctor, it can be ridiculously uncomfortable and really take over a patient’s life,” says Malone. […] Fortunately, most underlying causes of anal itching are treatable with lifestyle changes or medications. However if you’re also experiencing anal bleeding along with your itching or the itching becomes severe, you should see a doctor to make sure there isn’t a more serious problem like inflammatory bowel disease or cancer.

• #20 Itchy Anus STD: Causes, Symptoms, Treatment

  https://www.verywellhealth.com/itchy-anus-std-5443108

  Sexually transmitted infections (STIs), also known as sexually transmitted diseases (STDs), are an infection that is primarily spread through sexual contact. The high rates of STIs in the United States make it a national health concern. Chlamydia and gonorrhea are the two most common STIs in the United States. […] STIs can cause anal itching. It is a common symptom of several STIs like herpes, gonorrhea, warts, and crabs. […] Gonorrhea is the second most common STI in the United States. […] However, when someone does have symptoms, their symptoms can include: […] Anal itching […] Yes, anal itching is a common symptom of STIs. It is a symptom of gonorrhea, anal herpes, anal warts, and crabs. However, anal itching is also a symptom of several other conditions not related to STIs. Always talk to a healthcare provider to get the correct diagnosis.

• #21 Proctitis and Anusitis: Background, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/192910-overview

  The prevalence of proctitis in the general population has not been established through epidemiologic studies. However, it is possible to ascertain the incidence of proctitis through analysis of specific disease states. For example, patients with UC displayed a 31-50% frequency of proctitis upon diagnosis, depending on age at diagnosis. A study in the pediatric UC population demonstrated a significant increase in the occurrence of proctitis in female children as compared with males. […] The frequency of chronic radiation-induced proctitis has been reported to be in the range of 2-20% and is influenced by total radiation dose, mode of delivery, and dose fractionation. […] Infectious proctitis is typically due to sexually transmitted disease (STD) and is more common in those with a history of anal receptive intercourse. Of these infections, gonorrhea and chlamydia were the most common STDs, followed by herpes and syphilis. Some studies have reported the incidence of gonorrheal and chlamydial proctitis among men who have sex with men (MSM) to be as high as 8.5% and 7.9%, respectively.

• #22 Perianal Streptococcal Dermatitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0115/p391.html

  Perianal streptococcal dermatitis is caused by group A beta-hemolytic streptococci and occurs mainly in children between six months and 10 years of age. In one study, the incidence was reported to range from one in 218 to one in 2,000 pediatric outpatient visits. Signs and symptoms in this study included perianal dermatitis (90 percent), perianal itching (78 percent), rectal pain (52 percent) and blood-streaked stools (35 percent). Intrafamily spread was reported in 50 percent of possible cases. Communal bathing is thought to facilitate familial spread; however, the incidence of communal bathing did not reach statistical significance in this study. […] Children with streptococcal pharyngitis have a 6 percent anal carriage rate. It is thought that gastric acid in a healthy host eliminates most of the swallowed pharyngeal bacteria; therefore, other sources of transmission are likely. Digital contamination from an infected oropharynx or other sites of streptococcal infection (i.e., impetigo) may be the source.

• #23 Perianal Streptococcal Dermatitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0115/p391.html

  Perianal streptococcal dermatitis is caused by group A beta-hemolytic streptococci and occurs mainly in children between six months and 10 years of age. In one study, the incidence was reported to range from one in 218 to one in 2,000 pediatric outpatient visits. Signs and symptoms in this study included perianal dermatitis (90 percent), perianal itching (78 percent), rectal pain (52 percent) and blood-streaked stools (35 percent). Intrafamily spread was reported in 50 percent of possible cases. Communal bathing is thought to facilitate familial spread; however, the incidence of communal bathing did not reach statistical significance in this study. […] Children with streptococcal pharyngitis have a 6 percent anal carriage rate. It is thought that gastric acid in a healthy host eliminates most of the swallowed pharyngeal bacteria; therefore, other sources of transmission are likely. Digital contamination from an infected oropharynx or other sites of streptococcal infection (i.e., impetigo) may be the source.

• #24 Perianal Streptococcal Dermatitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0115/p391.html

  Perianal streptococcal dermatitis is caused by group A beta-hemolytic streptococci and occurs mainly in children between six months and 10 years of age. In one study, the incidence was reported to range from one in 218 to one in 2,000 pediatric outpatient visits. Signs and symptoms in this study included perianal dermatitis (90 percent), perianal itching (78 percent), rectal pain (52 percent) and blood-streaked stools (35 percent). Intrafamily spread was reported in 50 percent of possible cases. Communal bathing is thought to facilitate familial spread; however, the incidence of communal bathing did not reach statistical significance in this study. […] Children with streptococcal pharyngitis have a 6 percent anal carriage rate. It is thought that gastric acid in a healthy host eliminates most of the swallowed pharyngeal bacteria; therefore, other sources of transmission are likely. Digital contamination from an infected oropharynx or other sites of streptococcal infection (i.e., impetigo) may be the source.

• #25 13 Reasons Your Butthole Itches and How to Get Quick Relief

  https://www.businessinsider.com/guides/health/conditions-symptoms/why-does-my-butthole-itch

  Sexually transmitted infections that can lead to perianal itching include gonorrhea, herpes, HPV, and chlamydia. […] Pinworm infections are the most common intestinal-worm infection in the United States. […] Anal cancer occurs when malignant cells form in the tissue around the anus. Many cases of anal cancer are caused after contracting human papillomavirus (HPV). […] Anal itching is more common than you might think, and „while anal itching may sound like a trivial reason to see a doctor, it can be ridiculously uncomfortable and really take over a patient’s life,” says Malone. […] Fortunately, most underlying causes of anal itching are treatable with lifestyle changes or medications. However if you’re also experiencing anal bleeding along with your itching or the itching becomes severe, you should see a doctor to make sure there isn’t a more serious problem like inflammatory bowel disease or cancer.

• #26 Itchy Anus Symptoms, Causes & Treatments | Spire Healthcare

  https://www.spirehealthcare.com/symptoms/itchy-anus/

  An itchy anus is a very common condition and can happen to anyone at any age. […] It has been suggested that 1 to 5 people in every 100 have an itchy anus. […] An itchy anus can also be a symptom of these common conditions: […] Certain cancers eg anal cancer, bowel cancer, lymphoma or rectal cancer these are rare causes of an itchy anus. […] Threadworms are more common in children, with four in 10 children having threadworms at some point. However, if a child in a household has threadworms, it is likely that adults in the same household will catch it.

• #27

  https://journals.lww.com/itch/fulltext/2018/06000/evaluation_of_the_symptom_of_itch_ambulatory.4.aspx

  This study finds 129 million itch visits occurred, averaging 5.6 million visits per year. […] There is seasonality to itch visits, with the largest numbers occurring in summer and fewest in winter. […] These data provide insights for further investigation into the burden of itch-related diseases. […] Although we do have some insights into the epidemiology of itch, limited work is ongoing in understanding the impact of itch across entire populations. […] The present study extends the scope of this earlier analysis, and in doing so utilizes a longer study interval and somewhat different analytic approaches to add to this earlier work. […] In order to estimate under-reporting of itch as a symptom, the leading 5 rank-order diagnoses were evaluated for the proportion of visits at which itch was reported.

• #28 Evaluation, management and future perspectives of anal pruritus: a narrative review | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-023-01018-5

  There are up to 100 conditions leading to perianal itching, which makes differential diagnostics and treatment quite challenging. […] In view of that, a thorough history and digital examination is of great importance. […] The onset of the disease varies, but more often patients experience itch during the night or in the hot weather. […] In several studies tobacco use, alcohol and several food products, such as milk, chocolate, citrus or tomatoes have been linked to idiopathic anal pruritus. […] A thorough general physical examination may expose other sites of dermatological conditions, allergies and infections. […] Anoscopy should be performed for all the patients with anal pruritus to identify commonly associated proctological diseases such as hemorrhoids, anal fistula or fissures as this would change the therapeutic approach later on.

• #29 Pruritus Ani

  https://mobile.fpnotebook.com/GI/Sx/PrtsAn.htm

  Pruritus Ani Prevalence: 1-5% of population in the United States […] Conservative therapy is effective in 89% of patients […] Failure to improve (11% of cases) should prompt further evaluation for underlying cause.

• #30 Pruritus Ani

  https://fpnotebook.com/GI/Sx/PrtsAn.htm

  Pruritus Ani Prevalence: 1-5% of population in the United States. […] Conservative therapy is effective in 89% of patients. […] Failure to improve (11% of cases) should prompt further evaluation for underlying cause.

• #31 Itch, pruritus

  https://dermnetnz.org/topics/pruritus

  The epidemiology of pruritus depends on its underlying cause or causes. However, in general, the incidence of chronic pruritus increases with age, it is more common in women, and in those of Asian background. […] Systemic diseases may cause generalised pruritus. This is sometimes called metabolic itch. There is nothing wrong with the skin itself, at least until it’s been scratched. […] Uraemic pruritus arises in patients undergoing dialysis is due to a combination of xerosis (dry skin), secondary hyperparathyroidism, peripheral neuropathy (nerve changes) and inflammation. […] Hepatogenic pruritus is more common in intrahepatic than extrahepatic cholestasis. Examples of intrahepatic cholestasis are that associated with chronic viral hepatitis, primary biliary cirrhosis, pregnancy-related cholestasis. […] Paraneoplastic itch is associated with lymphoma, especially Hodgkin lymphoma, leukaemia or a solid organ tumour (eg lung, colon, brain). […] Infections causing itch include human immunodeficiency virus infection (HIV) and hepatitis C virus.

• #32

  https://link.springer.com/article/10.1007/s40257-024-00898-5

  Neuropathic itch is a common origin of chronic pruritus, accounting for an estimated 8% of cases in the general population, according to a German database. […] Epidemiological studies exploring the prevalence and incidence of neuropathic itch are notably lacking in the existing literature. […] The most common forms of neuropathic itch are BRP, NP, and anogenital itch, albeit there are no detailed epidemiologic data. […] Identifying the cause of neuropathic itch can be a convoluted process, and recognizing key epidemiological factors may be a helpful tool in narrowing the potential contributing mechanisms. […] BRP, for instance, is 23 times more commonly seen in white women in the fifth to sixth decades of life. […] The prevalence of BRP in the general population is unknown, although it is considered to be rare.

• #33

  https://link.springer.com/article/10.1007/s40257-024-00898-5

  Similar to BRP, NP is 23 times more likely to occur in women than men and is commonly seen in middle-aged individuals, although pediatric cases are possible. […] Despite its impact on individuals worldwide, the general prevalence of NP remains to be elucidated. […] Anogenital pruritus refers to itch localized to the anal, perianal, or genital skin. […] The prevalence of anogenital itch may differ on the basis of the areas affected. […] In general, anogenital pruritus impacts 15% of the adult population. […] The true prevalence of vulvar and anogenital itch is likely gravely underestimated, given patients may be hesitant or embarrassed to report this symptom. […] This reluctance can lead to underreporting, which contributes to the underestimation of the true prevalence of these conditions. […] The stigma attached to discussing genital symptoms can also discourage patients from seeking medical advice, resulting in delayed diagnosis and treatment.

• #34 Evaluation, management and future perspectives of anal pruritus: a narrative review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9892672/

  Anal pruritus is defined as a condition characterized by itching around the perianal region. It affects around 15% of the general adult population, and it is four times more common in men than women. […] Although not life threatening, when long lasting this condition can greatly impair patients quality of life and even result in psychological issues. […] There are up to 100 conditions leading to perianal itching, which makes differential diagnostics and treatment quite challenging. […] In view of that, a thorough history and digital examination is of great importance. […] Infectious etiologies are quite often diagnosed in patients with anal pruritus, thus microbiological investigation should be considered in a high-risk patient. […] Although not widely used in clinical practice, several additional classification systems have been proposed by various authors.

• #35 Evaluation, management and future perspectives of anal pruritus: a narrative review | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-023-01018-5

  Anal pruritus is defined as a condition characterized by itching around the perianal region. It affects around 15% of the general adult population, and it is four times more common in men than women. […] Although, not life threatening, when long lasting this condition can greatly impair patients quality of life and even result in psychological issues. […] It is mainly categorized as either primary (idiopathic) or secondary, being a consequence of causal pathology. […] The main linking factor of the idiopathic pruritis is thought to be an increased fecal contamination of the anal region. […] Several studies showed abnormal sphincter relaxation leading to fecal soiling and perianal irritation initiating what is called an itchscratch cycle. […] In this narrative review we overview the classification, diagnostics and possible treatment options of anal pruritus.

• #36 Patch testing in patients with anal itching | The BMJ

  https://www.bmj.com/content/355/bmj.i6269

  Perianal dermatoses and pruritus ani are common and socially embarrassing conditions that are often poorly managed. […] Patch testing is important in

• #37

  https://link.springer.com/article/10.1007/s40257-024-00898-5

  Similar to BRP, NP is 23 times more likely to occur in women than men and is commonly seen in middle-aged individuals, although pediatric cases are possible. […] Despite its impact on individuals worldwide, the general prevalence of NP remains to be elucidated. […] Anogenital pruritus refers to itch localized to the anal, perianal, or genital skin. […] The prevalence of anogenital itch may differ on the basis of the areas affected. […] In general, anogenital pruritus impacts 15% of the adult population. […] The true prevalence of vulvar and anogenital itch is likely gravely underestimated, given patients may be hesitant or embarrassed to report this symptom. […] This reluctance can lead to underreporting, which contributes to the underestimation of the true prevalence of these conditions. […] The stigma attached to discussing genital symptoms can also discourage patients from seeking medical advice, resulting in delayed diagnosis and treatment.

• #38 Pruritus Ani

  https://fpnotebook.com/GI/Sx/PrtsAn.htm

  Pruritus Ani Prevalence: 1-5% of population in the United States. […] Conservative therapy is effective in 89% of patients. […] Failure to improve (11% of cases) should prompt further evaluation for underlying cause.

• #39 Pruritus Ani

  https://mobile.fpnotebook.com/GI/Sx/PrtsAn.htm

  Pruritus Ani Prevalence: 1-5% of population in the United States […] Conservative therapy is effective in 89% of patients […] Failure to improve (11% of cases) should prompt further evaluation for underlying cause.

• #40

  https://link.springer.com/article/10.1007/s43472-024-00130-z

  Anal pruritus is a frequent disorder accounting for many proctological consultations, affecting mainly middle-aged males. […] Anal itching affects about 1 to 5% of the population, with a higher prevalence in men (4:1). […] It represents the second most common proctological complaint after haemorrhoids. […] The treatment relies on the identification of a potential aetiology, and should be based on a step-up approach. […] Anal pruritus is a common source of proctological consultations, and the appropriate management depends on the identification of a potential secondary cause through rigorous history taking, physical examination and directed complementary investigations.

• #41 Evaluation, management and future perspectives of anal pruritus: a narrative review | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-023-01018-5

  Infectious etiologies are quite often diagnosed in patients with anal pruritus, thus microbiological investigation should be considered in a high-risk patient. […] Although not widely used in clinical practice, several additional classification systems have been proposed by various authors. […] Management of patients with anal pruritus may be challenging and long lasting. […] For instance, the infectious pruritus causes should be treated with antiviral, antibiotic, antifungal or anthelminthic medicine, according to the detected microorganisms. […] Similarly, when a proctological disease such as hemorrhoids, anal fistula or fissure are suspected to be the underlying cause of pruritus, the treatment of these conditions usually, but not always, bring relief from pruritus symptoms. […] In long lasting intractable idiopathic pruritus cases, intradermal methylene blue injections may be used as a solution. […] Although initial results of these novel treatment agents are promising, further research is warranted to determine their safety and effectiveness for treating idiopathic anal pruritus.

• #42 Evaluation, management and future perspectives of anal pruritus: a narrative review | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-023-01018-5

  Infectious etiologies are quite often diagnosed in patients with anal pruritus, thus microbiological investigation should be considered in a high-risk patient. […] Although not widely used in clinical practice, several additional classification systems have been proposed by various authors. […] Management of patients with anal pruritus may be challenging and long lasting. […] For instance, the infectious pruritus causes should be treated with antiviral, antibiotic, antifungal or anthelminthic medicine, according to the detected microorganisms. […] Similarly, when a proctological disease such as hemorrhoids, anal fistula or fissure are suspected to be the underlying cause of pruritus, the treatment of these conditions usually, but not always, bring relief from pruritus symptoms. […] In long lasting intractable idiopathic pruritus cases, intradermal methylene blue injections may be used as a solution. […] Although initial results of these novel treatment agents are promising, further research is warranted to determine their safety and effectiveness for treating idiopathic anal pruritus.

• #43

  https://journals.lww.com/itch/fulltext/2018/06000/evaluation_of_the_symptom_of_itch_ambulatory.4.aspx

  This study finds 129 million itch visits occurred, averaging 5.6 million visits per year. […] There is seasonality to itch visits, with the largest numbers occurring in summer and fewest in winter. […] These data provide insights for further investigation into the burden of itch-related diseases. […] Although we do have some insights into the epidemiology of itch, limited work is ongoing in understanding the impact of itch across entire populations. […] The present study extends the scope of this earlier analysis, and in doing so utilizes a longer study interval and somewhat different analytic approaches to add to this earlier work. […] In order to estimate under-reporting of itch as a symptom, the leading 5 rank-order diagnoses were evaluated for the proportion of visits at which itch was reported.

• #44

  https://journals.lww.com/itch/fulltext/2018/06000/evaluation_of_the_symptom_of_itch_ambulatory.4.aspx

  The 5 most common diagnoses in which itching is reported are dermatitis not otherwise specified, vaginitis and vulvovaginitis, candidiasis of the vulva and vagina, unspecified pruritic disorder, and atopic dermatitis. […] An additional point is noteworthy regarding vulvovaginal conditions including candidiasis and vaginitis and vulvovaginitis are commonly associated with itching, yet under-represented in the dermatology literature. […] The most important limitation of this analysis is that many other diseases itch, yet are not explicitly captured. […] This paper presents an updated and expended understanding of ambulatory, office-based care for itching in the United States.

• #45

  https://link.springer.com/article/10.1007/s40257-024-00898-5

  Neuropathic itch is a common origin of chronic pruritus, accounting for an estimated 8% of cases in the general population, according to a German database. […] Epidemiological studies exploring the prevalence and incidence of neuropathic itch are notably lacking in the existing literature. […] The most common forms of neuropathic itch are BRP, NP, and anogenital itch, albeit there are no detailed epidemiologic data. […] Identifying the cause of neuropathic itch can be a convoluted process, and recognizing key epidemiological factors may be a helpful tool in narrowing the potential contributing mechanisms. […] BRP, for instance, is 23 times more commonly seen in white women in the fifth to sixth decades of life. […] The prevalence of BRP in the general population is unknown, although it is considered to be rare.

• #46

  https://journals.lww.com/itch/fulltext/2018/06000/evaluation_of_the_symptom_of_itch_ambulatory.4.aspx

  The 5 most common diagnoses in which itching is reported are dermatitis not otherwise specified, vaginitis and vulvovaginitis, candidiasis of the vulva and vagina, unspecified pruritic disorder, and atopic dermatitis. […] An additional point is noteworthy regarding vulvovaginal conditions including candidiasis and vaginitis and vulvovaginitis are commonly associated with itching, yet under-represented in the dermatology literature. […] The most important limitation of this analysis is that many other diseases itch, yet are not explicitly captured. […] This paper presents an updated and expended understanding of ambulatory, office-based care for itching in the United States.

• #47 Infektionskrankheiten der Haut | The itchy bottom: causes and treatment | springermedizin.at

  https://www.springermedizin.at/infektionskrankheiten-der-haut/hautpflege/the-itchy-bottom-causes-and-treatment/27197284

  Anal pruritus is a frequent disorder accounting for many proctological consultations, affecting mainly middle-aged males. […] Anal itching affects about 1 to 5% of the population, with a higher prevalence in men (4:1). […] It represents the second most common proctological complaint after haemorrhoids.

• #48

  https://link.springer.com/article/10.1007/s43472-024-00130-z

  Anal pruritus is a frequent disorder accounting for many proctological consultations, affecting mainly middle-aged males. […] Anal itching affects about 1 to 5% of the population, with a higher prevalence in men (4:1). […] It represents the second most common proctological complaint after haemorrhoids. […] The treatment relies on the identification of a potential aetiology, and should be based on a step-up approach. […] Anal pruritus is a common source of proctological consultations, and the appropriate management depends on the identification of a potential secondary cause through rigorous history taking, physical examination and directed complementary investigations.

• #49 13 Reasons Your Butthole Itches and How to Get Quick Relief

  https://www.businessinsider.com/guides/health/conditions-symptoms/why-does-my-butthole-itch

  Sexually transmitted infections that can lead to perianal itching include gonorrhea, herpes, HPV, and chlamydia. […] Pinworm infections are the most common intestinal-worm infection in the United States. […] Anal cancer occurs when malignant cells form in the tissue around the anus. Many cases of anal cancer are caused after contracting human papillomavirus (HPV). […] Anal itching is more common than you might think, and „while anal itching may sound like a trivial reason to see a doctor, it can be ridiculously uncomfortable and really take over a patient’s life,” says Malone. […] Fortunately, most underlying causes of anal itching are treatable with lifestyle changes or medications. However if you’re also experiencing anal bleeding along with your itching or the itching becomes severe, you should see a doctor to make sure there isn’t a more serious problem like inflammatory bowel disease or cancer.

• #50 Approach to the patient with anal pruritus – UpToDate

  https://www.uptodate.com/contents/approach-to-the-patient-with-anal-pruritus

  Anal pruritus is estimated to affect 1 to 5 percent of the general population. However, most of these patients probably do not come to medical attention. Anal pruritus is more common in the fourth to sixth decades of life and has a higher prevalence in males. […] Approximately 75 percent of cases of anal pruritus are secondary to inflammatory, infectious, systemic, neoplastic, and anorectal disorders that contribute to or underlie the development of pruritus.

• #51

  https://journals.lww.com/itch/fulltext/2018/06000/evaluation_of_the_symptom_of_itch_ambulatory.4.aspx

  This study finds 129 million itch visits occurred, averaging 5.6 million visits per year. […] There is seasonality to itch visits, with the largest numbers occurring in summer and fewest in winter. […] These data provide insights for further investigation into the burden of itch-related diseases. […] Although we do have some insights into the epidemiology of itch, limited work is ongoing in understanding the impact of itch across entire populations. […] The present study extends the scope of this earlier analysis, and in doing so utilizes a longer study interval and somewhat different analytic approaches to add to this earlier work. […] In order to estimate under-reporting of itch as a symptom, the leading 5 rank-order diagnoses were evaluated for the proportion of visits at which itch was reported.

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