Pruritus Ani or Skin Rash?

Hello,

I have recently been dealing with some IBS issues.  My GI sent me to have a colonoscopy, which was totally normal.  I also have seen my PCP and a Colon Rectal doctor because of this itching and burning in my anus.

They've had me try Topicort, an Anti-Fungal & Steroid cream & Anucort suppositories.  None of which has produced any significant healing.  No over the counter cream has helped either besides desitin, which is diaper rash cream.

I have read about Pruritus Ani and I'm not convinced that's what is going on.  After trying all of these things, I have now what looks like a big red circular rash starting at my anus and going out about an inch radius.  It stopped itching but now is painful.  When the pain stops, it's itchy.  In the last week, it seems that my scotum has become itchy as well and part of it is more red than normal.

Anyway, I was wondering if it is time to see a Dermatologist?  The Colonoscopy yielded no internal invaders but the Dr. said my anus & rectum looked completely normal.  He told me the itchiness is probably due from constipation but going more makes it totally worse and it leaves the area raw.  Nothing I do or don't do is helping.  I try to keep it as clean as possible.  

The only other note that I find might be worthwhile is that prior to this issue, I was being treated for supposed Prostatitis, which eventually didn't turn out to be that, and the Urologist & his office had me on two months of Cipro 500mg twice a day, then one month of Bactrum 500mg twice a day.  I feared that this ruined the normal flora in my bowels, so I just started to take a probiotic.  

Anyway, here is a chronology of all the entire thing:
1. Jock Itch
2. Pain in Testicles/Genitals/Perianal Area/Rectum
3. Above symptoms lead to supposed Prostatitis diagonsis
4. IBS troubles start
5. Begin to use Cirtacel & Miralax
6. IBS troubles go away (Stop using Miralax)
7. After 5 months (3 months of heavy antibiotics) pain in groin goes away
8. Itching & burning in anus begins
9. Doctors find nothing significant with anus/colon, site moderate irritation
10. Red around anus gets worse looks very bad... itching begins in perianal & scrotum areas.

Please help.  I've had a really bad run of things and I feel better, I just need to get rid of this one thing and it's around -3 weeks to get into a dermatologist.  I'm so frustrated and confused.

Thank you very much,
Steve

[Bhupinder Kaur, MD]

Hello,
From your symptoms the possibility of intertrigo needs to be ruled out. An intertrigo is an inflammation (rash) of the body folds.It most commonly occurs due to bacterial, viral or fungal infection. An intertrigo usually appears red and raw-looking, and may also itch, ooze, and be sore.

Keep the area clean and apply some topical antiseptics. Also wear loose-fitting cotton clothing and use an antibacterial soap or mild soap like dove. Avoid any kind of cosmetics. Topical zinc oxide cream like Sudocrem, Desitin are very helpful(apply with a paper towel and not directly with hands).Application of mild steroid cream like dermacort also helps. For the itching please take some over the counter antihistaminic like benadryl or Claritin. In case the symptoms persist then antifungals may be needed. Please consult a dermatologist in that case.
I hope it helps. Take care and regards.

[StevieD130]

Thank you.  I did see a dermatologist and he didn't think it was that bad.  I've been using the Desitin, which was helping.

He proscribed Alcortin A, so we'll see how that helps.