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August 1992

An Unusual Case of Pruritus Ani

Author Affiliations

Madigan Army Medical Center, Tacoma, Wash

Arch Dermatol. 1992;128(8):1115-1116. doi:10.1001/archderm.1992.01680180109016

REPORT OF A CASE  A 62-year-old white woman was referred to the outpatient dermatology clinic with a complaint of perianal itching for 10 years as well as "calluses" in her perianal area for many years. Over the last year, she noted increasing pain in the area of her left buttock and a persistent serosanguineous discharge from the perianal lesions. Also significant was a 1-year history of decreasing caliber of her stools. She denied weight loss, use of tobacco, or history of condyloma acuminatum. She did admit to a long history of hemorrhoids.Examination of the perianal area revealed two 3 × 4-cm, dark-red, friable plaques extending from the anal orifice (Fig 1). Further examination revealed a 3 × 2-cm mass located within the anal canal. No adenopathy was noted. Histologic appearance of the lesion is depicted in Figs 2 and 3.What is your diagnosis?

DIAGNOSIS:  Anal margin squamous cell carcinoma (SCC).