Although often considered a minor ailment, especially by those not afflicted with it, pruritus ani is at best a source of great annoyance and embarrassment and at worst may become so distracting as to result in suicide. Because the perianal skin is rich in sensory nerve endings, it is particularly liable to itching. If the itching is persistent, progressive skin changes leading to lichenification occur. According to Fromer,1 pruritus is a modified sensation of pain and, although produced by a weaker stimulus than pain, it may be more intolerable than the pain produced by a stronger stimulus. This is the basis for scratching, which by denuding the skin substitutes tolerable pain for itching. There is some question as to whether an idiopathic form of pruritus ani exists or whether all perianal itching is secondary to some cause that in the idiopathic case is not readily discoverable. Copland2 has
PRURITUS ANI. JAMA. 1956;162(8):732. doi:10.1001/jama.1956.02970250032010
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