Abstract
Twenty-three patients with pruritus ani associated with anal mycosis underwent primary treatment of a concurrent anal disorder. The anal disorders included haemorrhoids (n=9), fissure (n=8), anal spasm without fissure (n=5), and occult mucosal prolapse (n=1). Pretreatment investigation of faeces for parasites was negative. The glucosal tolerance test and white blood cell count were normal in all cases. Culture of skin smears from the perianal region was positive for Candida only in 16 patients, Dermatophytes only in 6 and a combination of both in 1 patient. Following the appropriate proctological procedure, pruritus resolved or markedly improved in 20 patients. The remaining three patients required antifungal treatment with econazole. Two of these, however, continued to complain of pruritus. It is suggested that in patients with pruritus ani associated with perianal mycosis, antimycotic therapy should be used only if fungal infection persists after treatment of the underlying proctological disease.
Résumé
23 malades avec un prurit anal associé avec une mycose anale ont subi un traitement primaire d'une maladie anale concomitante. Cette maladie anale était soit des hémorroides (n=9), une fissure (n=8), un spasme anal sans fissure (n=5), et un prolapsus muqueux interne (n=1). La recherche de parasites dans les selles était négative. Le test de tolérance glucidique et le nombre de globules blancs sanguins étaient normaux dans tous les cas. La culture des prélèvements cutanées de la région périanale était positive pour le Candida seulement chez 16 patients, pour les Dermophites chez 6 patients et la combinaison des 2 chez un seul patient. A la suite d'un traitement proctologique approprié, le prurit a disparu ou a été nettement amélioré chez 20 patients. Les 3 patients restants ont nécessité un traitement antifongique avec econasol. 2 d'entre eux cependant ont continué à se plaindre de prurit. On suggère que chez les patients qui ont un prurit anal associé à une mycose périanale la thérapeutique antimycotique ne soit utilisée qu'en cas d'infection fongique persistante après un traitement des affections proctologiques associées.
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Pirone, E., Infantino, A., Masin, A. et al. Can proctological procedures resolve perianal pruritus and mycosis?. Int J Colorect Dis 7, 18–20 (1992). https://doi.org/10.1007/BF01647655
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DOI: https://doi.org/10.1007/BF01647655