Perianal skin with eczema
Introduction
Introduction Perianal eczema is a common non-infectious skin disease. The lesions are mostly confined to the skin around the anus. It also occasionally spreads to the buttocks, perineum and clitoris. Local rash, erythema, erosion, exudation, scarring, and detachment may occur. Chips. The course of the disease is long, the skin around the anus is often thickened, the color is gray or dark red, rough, so that cleft palate, exudation, itching, repeated hair as the main feature, can occur at any age.
Cause
Cause
The etiology of eczema is complex and variable, and it is caused by a variety of factors, including physical, chemical, biological external factors and internal neurological imbalances, metabolic dysfunction, organ dysfunction, manifested in clinical is a non-special Heterosexual allergic reaction, it is difficult to confirm that a simple factor causes eczema, and it is difficult to cure the symptoms by eliminating a certain factor. The cause is divided into primary and secondary, the former cause is unknown, the latter is mostly caused by inflammation or secretions such as anal fistula and anal fissure. There are several common factors:
(a) allergic reaction
This is the main cause of the disease, both internal and external, such as infections, sensitized foods, drugs or exposure to certain allergens.
(two) disease factors
In certain diseases such as endocrine disorders, malnutrition, digestive disorders, intestinal parasitic diseases, etc., the patient's sensitivity to certain allergic substances is easily induced.
(three) local lesions
Chronic inflammatory stimuli such as sputum, anal fistula, anal fissure, anal incontinence and other diseases can also be induced.
(4) irritating factors
The anus is directly stimulated by iodine, alcohol, strong acid and alkali to induce eczema.
(5) Neurological dysfunction and endocrine disorders
This disease can also be induced by excessive fatigue, mental stress, depression, and insomnia.
Examine
an examination
Related inspection
Anal examination
(a) acute eczema
Acute eczema in any part is generally followed by flushing-pap (plaque)-blister (exudation)-smash-scarring (scaly)-pigmentation, accompanied by itching. The clinical manifestation is that the effusion is obvious, and the strict exudation is dripping. The severe itching makes the patient difficult to tolerate. Due to scratching, scratches, blood stasis, bacterial infection, pustules, purulent exudation, Purulent crusting, showing the unique appearance of eczema, that is, multiple types of rashes exist simultaneously. Anal skin is a sensitive area, acute eczema itching is particularly intense, fecal contamination is more likely to cause bacterial infection, symptoms are more severe, can expand and perineum, scrotum, buttocks skin, affecting patients' lives and work, making the course extremely unstable, prolonged treatment And turned into a chronic process.
(two) chronic eczema
Perianal chronic eczema is more common than acute eczema. Local manifestations include thickening of the skin, changes in moss, obvious wrinkles and cleft palate, tendency to exude, severe itching, chronic passage, and easy recurrence.
Diagnosis
Differential diagnosis
The differential diagnosis of eczema in the perianal skin:
1, the perianal skin has eczema and anal pruritus identification: eczema often has papules, erythema, exudation, erosion, secondary itching, and the latter often itchy, no exudate, sputum , secondary oozing, bleeding, erosion.
2, the perianal skin has the identification of eczema and contact dermatitis: the latter has a clear history of contact stimulation, easy to find out, the rash is limited to the contact site, the shape is single, the blisters are large, the realm is clear, after removing the cause, the dermatitis subsides Fast, rarely relapse.
3, the perianal skin has eczema and perianal neurodermatitis: the latter often itching, after the appearance of flat papules, there are mossy changes, light brown, dry and solid, the lesion can be extended to the appendix, perineum and scrotum .
