pruritis ani or something else

I've had an ongoing problem for 2.5 months.  I finally went to a proctologist 4 weeks ago and was diagnosed with pruritis ani and prescribed triamcinalone lotion three time per day.  I applied this for about one week, and the problem continued.  I have intense itching, which is sometimes resolved by taking a warm bath, and a slight clear like discharge.  While I've been waiting to get back into the proctologist, I went to see a GP, who prescribed metronidazole.  After 2 days of metronidazole (500mg 3xday), all of my lymph nodes (particularly my groin) are swollen, I've developed a rash across my torso (no itching), and I feel like feverish/sick  The metronidazole has helped a little with the itching and swelling around my anus, but it is still definately present.  I've been tested for STD's except gonnorhea (Gonorrhea) and chlamydia (I don't know why the docs didn't order these) and I also have psoriasis, but never like this on my torso or around my anus.

[Bhupinder Kaur, MD]

Hello,
Since most of the STD’s have come out clear, so it can be due to skin problems such as psoriasis, seborrhea and eczema. Sometimes hemorrhoids will start off as red rash and anal itching. Also sweating, moisture due to sitting, pinworms and friction rub with clothes can cause pruritis ani.

I suggest you to get all these possibilities evaluated from your dermatologist. Till that time,try an over-the-counter (OTC) cream or ointment containing hydrocortisone but it is to be applied sparingly to the affected area. A protective ointment that contains zinc oxide (Desitin, Balmex) also may help. If your symptoms are worse at night, please take an antihistamine like Benadryl to reduce itching until topical treatments take effect.

I hope it helps . Take care and regards.