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JAMA Dermatology a Century Ago
May 2013

Pruritus Ani, Recurring After Plastic Operation for Its Cure.

Author Affiliations


JAMA Dermatol. 2013;149(5):528. doi:10.1001/jamadermatol.2013.2957


Presented by DRS. PUSEY and STILLIANS.

The patient, aged forty-eight years, Jewish, was a small, spare-built man, highly nervous, who had suffered with severe pruritus ani for six years. Four years ago, for relief, a plastic operation had been performed, consisting of an excision of a wide section of the skin about the anus, on the theory that the itching could be removed with the skin. The pruritus promptly returned, worse than before, and since then had resisted all efforts to relieve it. Around the anus could be seen an area approximately three inches in diameter, resembling scar tissue, and covered with thick, white inelastic skin. This skin was sodden, excoriated from scratching, and very sensitive. The anal folds were deep and rigid, with many fissures. The scar tissue extended well into the anal orifice, which was distinctly strictured. Connected with this area was an extension about two inches long in the intergluteal fold; here the skin was white, and shiny but not so thick, nor so inelastic. This area was separated from the normal skin by an irregular red border, one-eighth to one-fourth inch wide.

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