Anal pruritus is a kind of skin disease with perianal pruritus as the common complaint, which occurs in young adults aged 20 ~ 40.
There are more men than women, which is more common among people who don't like sports at ordinary times. Itching is often aggravated at night, which often makes patients itch and wake up, leading to scratching and further aggravating itching. Itching is light and heavy, and when it is serious, I want to scratch my skin and cut off my anus.
To treat anal pruritus, finding the cause is the key! 1. TCM's understanding of the etiology of anal pruritus is mainly based on exogenous pathogenic factors, blood deficiency leading to wind, damp-heat betting of liver meridian, blood stasis leading to wind, and insect poison harassment.
Second, the understanding of modern medicine on the etiology of anal pruritus
Primary pruritus: there is no primary disease, and simple itching is the main symptom.
Secondary itching: caused by primary anorectal diseases and various skin diseases, it is often the symptom of the primary disease.
The common causes of secondary itching are as follows:
1. Anorectal diseases
Anorectal diseases, such as anal fissure, hemorrhoid, anal fistula, abscess, proctitis, anal sinusitis, anal papillitis, rectal prolapse, anal incontinence, etc. , can cause itching symptoms.
These diseases may cause perianal itching through local stimulation, secretion or abnormal relaxation of internal sphincter. Besides potential allergens and bacteria, endopeptidases produced by bacteria in feces can also cause itching and inflammation.
If the skin or spots around the anus harden, or form ulcers, accompanied by itching, even bleeding, pain, secretions and so on. You should be alert to the possibility of cancer.
In addition, there is another situation that needs special attention, that is, people with a history of unclean sexual intercourse must go to the dermatological department for treatment, because sexually transmitted diseases such as condyloma acuminatum and AIDS can also cause perianal and vulvar itching, so diagnosis and treatment must not be delayed.
2. Systemic diseases
Such as diabetes, liver and kidney diseases.
The content of sugar in the skin tissue of diabetic patients increases, which is easy for bacteria to multiply. In addition, the body's resistance is low, which is easy to cause skin itching and infection, and it is not easy to recover after infection.
Large fluctuations in blood sugar can easily lead to dysfunction of nerve endings and autonomic nerves, which can cause skin itching; Hyperglycemia leads to reduced perspiration, dry skin and itchy skin.
When the renal insufficiency complicated by diabetes mellitus has a high level of urea in the blood, it will also induce skin itching; In addition, diabetic patients with itchy skin are extremely sensitive to external stimuli.
For patients with primary biliary cirrhosis or biliary obstruction, the content of bile salts in blood and skin increases, which stimulates nerve endings and leads to itching;
Anal pruritus can also appear in uremia in the late stage of nephropathy;
Itching of hyperthyroidism skin may be related to hyperhidrosis, increased basal metabolic rate and emotional tension.
3. Fungal and bacterial infections
According to reports, fungal infection accounts for 65,438+05% of the causes of anal pruritus, which is mainly characterized by a well-defined annular or semi-annular or map-like erythema on the inner thigh or buttocks, with a layer of white phosphorus chips attached to the surface.
4. Parasitic infection
Parasitic diseases such as pinworm, ascaris lumbricoides and trichomonas vaginalis can cause anal pruritus. Enterobius vermicularis infection is more common in children, and children often have perianal itching, irritability, insomnia, grinding teeth, loss of appetite and other manifestations.
5. Dermatosis
Neurodermatitis, contact dermatitis, lichen planus, psoriasis, seborrheic dermatitis, vitiligo, squamous cell carcinoma, paget's disease and other skin diseases are also pathogenic factors.
In addition, food factors (to be updated); Drug factors, such as tetracycline, colchicine, quinidine and local anesthetic, can cause anal pruritus due to allergy.
Mental factors such as mental overexcitation, depression, neurasthenia, anxiety, stress, etc.
Environmental factors, such as poor sanitary conditions, buttocks often in a warm and humid environment, underwear not dry, wearing pants and underwear that are not easy to disperse sweat or too tight, will make it difficult for buttocks to emit sweat. But also will rub the anal skin and induce anal pruritus.