Perianal erythema

What is Perianal Erythema?

Perianal erythema (PE) is an inflammation of the skin around the anus that leads to redness, itching, and pain. It is commonly seen in patients with Crohn’s disease, hemorrhoids, and proctitis, though it can occur in otherwise healthy individuals. There are several causes of perianal erythema, including irritation from friction as a result of tight clothing, soaps, saliva, and feces. Other possible causes include skin disorders such as psoriasis and eczema, bacteria (especially e-coli) and viral infections, or a reaction to medications. The severity of symptoms can range from mild to severe and, if left untreated, can spread to involve the rest of the buttocks and the surrounding skin.

Symptoms of Perianal Erythema

The primary symptoms of PE include:

  • Redness of the skin near the anus
  • Itching, usually in the rectal area
  • Burning or stinging sensation in the area
  • Painful or uncomfortable defecation
  • Pus-like discharge or bloody stools
  • Frequent urge to defecate (frequency of more than 3-4 times daily is considered abnormal)
  • Skin lesions, lesions, or bumps

Diagnosis of Perianal Erythema

The diagnosis of PE requires the presence of redness and itching in the rectal area. Other peaks, such as skin lesions or bumps, may be indicative of other skin conditions. Your doctor will do a physical examination and, if symptoms are severe, a biopsy to confirm the diagnosis. After the diagnosis is confirmed, further testing may be necessary to rule out other potential causes. Your doctor may also take a stool sample to check for infections and/or parasites.

Treatment of Perianal Erythema

The treatment of perianal erythema depends on the underlying cause. Medications such as corticosteroids (for inflammation) and antibiotics (for infections) may be prescribed. In some cases UV light therapy, laser treatments, or creams may also be used. To reduce discomfort and irritation in the area, your doctor may recommend frequent sitz baths or coldpacks. It is also important to keep the area dry and avoid wearing clothing or underwear that is too tight. If the underlying cause is a skin disorder, such as psoriasis or eczema, treatment may include topical medications applied directly to the affected area.