2020年12月30日星期三

lidocaine for hemorrhoids,Perianal skin disease

    1. What are the anal skin diseases? What are their characteristics?

    There are many anal skin diseases, such as anal pruritus, anal eczema, anal neurodermatitis, anal contact dermatitis, anal skin ringworm, anal skin tuberculosis, anal condyloma acuminata, perianal hidradenitis, anal venereal diseases.

    (1) Anal pruritus: It is a neurological dysfunction skin disease. Confined around the anus and perineum, itching, and ants walking sensation.

    (2) Anal eczema: it is a non-infectious allergic skin disease. It is characterized by itching, exudation, and repeated attacks.

    (3) Anal neurodermatitis: It is a localized skin and nerve dysfunction skin disease. The clinical features are skin lichenification, severe itching, long course of disease, and easy recurrence.

    (4) Anal contact dermatitis: It is a superficial inflammation that occurs when the skin or mucous membrane contacts some foreign substances. The skin damage is confined to the contact area, and the cause is removed and the disease is quickly healed, with a short course and no recurrence.

    (5) Anal skin ringworm: It is mostly spread by tinea cruris, or caused by superficial mold, which is easy to get sick and is contagious.

    (6) Anal skin tuberculosis: It is caused by Mycobacterium tuberculosis infection, the secretion is purulent, large in quantity, and infectious.

    (7) Anal condyloma acuminata: a new biotype lesion of skin and mucous membrane caused by virus. It mainly grows at the junction of skin and mucous membrane. Condyloma acuminatum is pedicled, clustered, and has a strong tendency to become cancerous.

    (8) Perianal hidradenitis: It is a purulent disease caused by chronic infection of the apocrine glands around the anus. Complex sinus fistulas can be formed under the skin of the anus.

    (9) Anal venereal disease: a chronic infectious disease caused by Treponema pallidum. It is mainly transmitted through sexual intercourse and is relatively rare in clinical practice.

    Of the various anal skin diseases mentioned above, anal pruritus and anal eczema are the most common clinically.

    Most of the above diseases have different degrees of itching during the onset, and a few have redness, swelling and pain. If they are not treated in time, they will cause chronic attacks, which will not heal for a long time, and some may have malignant changes. Therefore, if there is anal skin disease, it should be diagnosed and treated in time.

    2. What is anal pruritus?

    Anal pruritus is a neurological dysfunction skin disease with only severe itching and no primary skin damage. This disease is more common in young adults between 20 and 40 years old, with more men than women. The skin of the anus is often scratched due to itching, so erosion, bleeding, obsessiveness, and scratches are often seen. In the case of secondary infections, there may be foul-smelling liquid. If it does not heal for a long time, the skin may appear rough, chapped, weakened elasticity, loss of luster and pigment. Sedimentary lichenoid sclerosis and other secondary damage.

    Anal itching is often a symptom of primary lesions, secondary to various skin diseases or other diseases, accompanied by obvious specific skin damage and primary lesions.

    3. Which diseases can cause anal itching?

    Disorders that cause anal pruritus can be found in:

    (1) Anal skin diseases: such as anal eczema, neurodermatitis, ringworm, warts, peripheral hidradenitis, abnormal sebaceous gland secretion, protein accumulation, venereal diseases, and the attachment of feces in the rectum to the anal folds can all stimulate the anal skin and cause itching .

    (2) Anorectal and perineal diseases: such as hemorrhoids, anal fistula, anal fissure, prolapse, anal incontinence, anal sinusitis, anal papillary hypertrophy, uterine prolapse, vaginitis, urethritis, prostatitis, etc., can all be stimulated and secreted by inflammation Increased content, causing anal itching.

    (3) Parasitic diseases: such as roundworms, worms, trichomonas vaginalis, and pubic lice can cause anal itching.

    (4) Endocrine diseases: Diabetes pruritus can spread to the anus due to increased skin sugar content and irritation of nerve endings; hyperthyroid skin pruritus may be caused by hyperhidrosis, increased basal metabolic rate, emotional tension, etc.

    (5) Mental pruritus: It can be widespread all over the body or anus and perineum, accompanied by neuropsychiatric symptoms.

    (6) Liver and kidney diseases: primary biliary cirrhosis, biliary obstruction, itching due to increased levels of bile salts in the blood and skin; in the later stage of kidney disease, uremia can also cause anal itching.

    4. What are the symptoms of anal pruritus?

    Intractable itching of the anal canal and around the anus is the main symptom of this disease. It is usually limited to the skin around the anus at first, mostly paroxysmal. The degree of itching varies. The labia, especially between the front and back seams of the perineum, is more itchy, more pronounced at night, sometimes like insects crawling, ants walking; sometimes like mosquito bites, fire roasting, making it difficult to sleep, restless and intolerable.

    At the beginning of the disease, there is no damage to the skin. Due to frequent scratching, scratches, blood scabs, tingling, pigmentation and lichen-like sclerosis or eczema-like changes can be seen in the affected area. Secondary infections may sometimes occur over time. Long, it can cause neurasthenia, lack of taste, lack of energy and other symptoms.

    5. Is it easy to cure anal pruritus?

    What is the prognosis of anal pruritus? The key question depends on whether the causative factors of this disease can be found. Relieving and avoiding the pathogenic factors is one of the important measures to treat anal pruritus. For secondary itching that can find a clear cause The primary diseases of pruritus, such as anal eczema, hemorrhoids, anal fistula, anal prolapse, parasitic diseases and other diseases, are targeted in the treatment, and pruritus is naturally easy to cure. For unexplained anal itching, it is difficult to cure if the condition is repeated.

    6. How to prevent anal pruritus?

    The preventive measures for anal pruritus are summarized in the following four points:

    (1) The systemic and local primary diseases that may cause anal pruritus should be treated promptly, such as hemorrhoids, anal fistulas, anal fissures, eczema, contact dermatitis, etc.

    (2) Avoid eating and contacting foods, chemicals, pollen, lacquer, spicy and other irritating foods that are allergic to yourself, and certain drugs.

    (3) The underwear worn should not be too tight or too hard to rub the skin, and do not rub the anus with paper or plant leaves with chemical dyes and ink writing. The toilet paper should be soft. After going to bed or before going to bed, it is advisable to use warm water or 1:5000 potassium permanganate liquid to clean the anus to keep the anus fresh and clean.

    (4) Avoid anxiety and excessive tension. Don't grab the skin around the anus with your hands, so as not to scratch and cause infection.

    7. What is anal eczema?

    Eczema, also known as immersion sore, blood rubella, four-curved wind or scrotal wind, or perianal wind in Chinese medicine, is a non-infectious, allergic, chronic and refractory inflammatory skin disease. Both men and women can suffer from it.

    Eczema is divided into acute eczema and chronic eczema. Chronic eczema is a transformation from acute eczema, so chronic eczema is more common, often recurring, and does not heal for a long time. Those who occur on the skin around the anus are called anal eczema.

    8. Can patients with anal eczema wash their anus with hot water?

    Patients with anal eczema often suffer from unbearable local itching and prefer to use hot water to fumigate the perianal skin for a momentary relief of itching. This cleaning method not only did not relieve the condition, but promoted itching and exudation. This is because the hot water stimulates the skin of the anus, causing increased secretions, exudation and soaking, resulting in increased inflammation of the local skin, and the disease cannot be cured for a long time. Therefore, patients with anal eczema cannot clean the anus with hot water.

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