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August 1995

Pruritus Ani in an Elderly Man

Author Affiliations

University of Navarra, Pamplona, Spain

Arch Dermatol. 1995;131(8):955-956. doi:10.1001/archderm.1995.01690200093019

REPORT OF A CASE  A 78-year-old man presented with a 6-month history of perianal pruritus. His history was noncontributory. His father died of colon carcinoma. Previously, at another hospital, the diagnosis of eczema with possible fungal infection was suggested, and he was treated with topical corticosteroids and antifungals without significant improvement. The patient noted an indurated, damp, painless, and mildly pruritic lesion in the perianal area several weeks earlier.There was an erythematous, slightly elevated, exudative, well-defined plaque with irregular borders (diameter, 4 cm), located in the intergluteal fold near the anus. Around that lesion a symmetrical, erythematous, and slightly desquamative plaque was apparent (Figure 1). Culture was positive for Candida albicans. Topical treatment with an imidazole was begun to limit the extension of the larger lesion. A biopsy specimen of the exudative plaque was stained with hematoxylineosin and is shown in Figure 2.What is your diagnosis?Figure 1.