Perianal Psoriasis: An Uncommon Cause of Chronic Anal Itching and Pain
DOI:
https://doi.org/10.54753/rsh.v2i1.2586Keywords:
Anal pruritus, Perianal psoriasis, psoriasis in adults, perianal erythemaAbstract
Perianal psoriasis is a chronic and uncommon condition in adulthood, whose low incidence and nonspecific clinical presentation pose a diagnostic challenge in clinical practice. We report the case of a 62-year-old man with a long-standing history of psoriasis who presented with burning, pruritus, and anal pain of six months’ duration, accompanied by a sensation of fissures in the perianal region. Physical examination revealed intense, well-demarcated erythema with silvery-white scaling and a linear ulcer, while paraclinical studies and video rectosigmoidoscopy showed no abnormalities. The diagnosis was established clinically and confirmed by dermatological evaluation, and outpatient treatment was initiated with topical clobetasol, aloe vera cream, hydrotherapy, and hygienic-dietary measures, resulting in a favorable course and resolution of symptoms. This case highlights the importance of considering perianal psoriasis in the differential diagnosis of chronic perianal dermatoses and demonstrates that conservative management based on conventional topical therapies and general measures can be effective in controlling symptoms and improving the patient’s quality of life.References
[1] Carrascosa, J. M., Puig, L., Belinchón-Romero, I., Salgado-Boquete, L., del Alcázar, E., Andrés-Lencina, J. J., Moreno, D., & de la Cueva, P. (2022). Practical update of the recommendations published by the Psoriasis Group of the Spanish Academy of Dermatology and Venereology (GPS) on the treatment of psoriasis with biologic therapy. Part 1: Concepts and general management of psoriasis with biologic therapy. Actas Dermo-Sifiliográficas, 113(3), 261–277. https://doi.org/10.1016/j.ad.2021.10.003
[2] Maenthaisong, R., Chaiyakunapruk, N., Niruntraporn, S., & Kongkaew, C. (2007). The efficacy of aloe vera used for burn wound healing: A systematic review. Burns, 33(6), 713–718. https://doi.org/10.1016/j.burns.2006.10.384
[3] Meeuwis, K. A., de Hullu, J. A., Massuger, L. F., van de Kerkhof, P. C., & van Rossum, M. M. (2011). Genital psoriasis: A systematic literature review on this hidden skin disease. Acta Dermato-Venereologica, 91(1), 5–11. https://doi.org/10.2340/00015555-0988
[4] Menter, A. (2016). Psoriasis and psoriatic arthritis overview. The American Journal of Managed Care, 22(8 Suppl), S216–S224.
[5] Menter, A., Strober, B. E., Kaplan, D. H., Kivelevitch, D., Prater, E. F., Stoff, B., Armstrong, A. W., Connor, C., Cordoro, K. M., Davis, D. M. R., Elewski, B. E., Gelfand, J. M., Gordon, K. B., Gottlieb, A. B., Kavanaugh, A., Kiselica, M., Korman, N. J., Kroshinsky, D., Lebwohl, M., & Elmets, C. A. (2019). Joint AAD–NPF guidelines of care for the management and treatment of psoriasis with biologics. Journal of the American Academy of Dermatology, 80(4), 1029–1072. https://doi.org/10.1016/j.jaad.2018.11.057
[6] Merola, J. F., Li, T., Li, W. Q., Cho, E., & Qureshi, A. A. (2016). Prevalence of psoriasis phenotypes among men and women in the USA. Clinical and Experimental Dermatology, 41(5), 486–489. https://doi.org/10.1111/ced.12805
[7] Raharja, A., Mahil, S. K., & Barker, J. N. (2021). Psoriasis: A brief overview. Clinical Medicine, 21(3), 170–173. https://doi.org/10.7861/clinmed.2021-0257
[8] Ryan, C., & Kirby, B. (2015). Psoriasis is a systemic disease with multiple cardiovascular and metabolic comorbidities. Dermatologic Clinics, 33(1), 41–55. https://doi.org/10.1016/j.det.2014.09.004
[9] Sandborn, W. J., Fazio, V. W., Feagan, B. G., & Hanauer, S. B. (2003). AGA technical review on perianal Crohn’s disease. Gastroenterology, 125(5), 1508–1530. https://doi.org/10.1016/j.gastro.2003.08.025
[10] Serban, E. D. (2018). Perianal infectious dermatitis: An underdiagnosed, unremitting and stubborn condition. World Journal of Clinical Pediatrics, 7(4), 89–104. https://doi.org/10.5409/wjcp.v7.i4.89
