Q&A

What is perianal dermatology? 

Perianal dermatology is an umbrella term covering skin conditions that develop in or near the anus. It consists of a strong band of muscles (internal and external anal sphincter complex) and exterior skin folds that expand during a bowel movement to allow stool to pass from the body. The skin on and around the anus is sensitive and delicate and therefore can be prone to many medical conditions that can cause pain, discomfort, or aesthetic issues. 

What are some common perianal dermatology conditions? Dermatology conditions evaluated and treated at Dr. Maziar Ghodsian include:

Anal skin tags 

Skin tags are typically harmless, but these excess growths of skin can become uncomfortable if they rub on the skin or clothes. 

Pilonidal Cyst/Sinus 

Pilonidal cyst/sinus is a pore that becomes infected and usually tracts upwards towards the tailbone forming an abscess, resulting in an often painful, red and inflamed area. 

Lichen Sclerosus

Lichen sclerosus is an autoimmune, chronic inflammatory scarring disorder of the genital and anal region characterized by the formation of white, patchy areas of thin skin. 

Perianal Ulcer 

Perianal ulcer is a sore on the skin surface that can be caused by sexually transmitted diseases, for example: syphilis, gonorrhea, herpes simplex, chlamydia, and human papillomavirus as well as cancer such as basal cell carcinoma, squamous cell carcinoma, and melanoma. 

Perianal Dermatitis 

Perianal Dermatitis is a broad term encompassing skin irritation around the anal opening sometimes caused by underlying conditions such as autoimmune skin conditions (lichen sclerosus, psoriasis, etc), infections (bacterial, fungal or viral in nature), inflammatory bowel disease, and skin dysplasia or malignancy. 

Anal dysplasia 

Anal dysplasia is a change in the architecture of the cells, usually at the level of the dentate line where the outside skin and the inside mucosa come together. If left untreated, anal dysplasia can develop into anal cancer. 

Anal Fissuring 

Anal Fissuring are superficial splits or tears around (perianal) or in the anal opening or tissues lining the anus. They often cause bleeding, itchiness and discomfort. 

Anal Fissure 

Anal Fissures are splits or tears in the lining of the anus (anal mucosa). Fissures extend deeper than fissuring, typically extending into the internal anal sphincter muscle. Symptoms of anal fissures include spasms, bleeding, pain, and burning. 

Anal warts (Condyloma) 

Anal warts or Condyloma are growths caused by the human papillomavirus that may present on the inside of the anal canal as well as the outside area around the anus. There can be a few scattered clusters or they can grow very large and extensive encompassing the entire anal canal circumferentially. They start off small but can develop into large or multiple growths covering the anal area and genital skin. 

Anal abscesses 

Anal abscesses typically arise from acute infections of the anal glands inside the anus typically at the level of the dentate line where the outside skin and the inside mucosa come together. Anal abscesses typically course through and make their way to the outside of the anus sometimes resulting in pain, swelling, and fever. Anal abscesses may also become life-threatening at times resulting in sepsis. 

Anal cancer 

Anal cancer may develop as a result of dysplastic or abnormal cell growth that begins to invade the surrounding tissues leading to tumor formation. 

Anal cancer can have symptoms of bleeding, abnormal growths, changes in bowel habits (ie alternating diarrhea and constipation), and worsening pain over time. If you are experiencing persistent pain or anal bleeding, see your provider/specialist immediately. 

Anal Psoriasis 

Anal psoriasis is a type of genital psoriasis. Anal psoriasis is a chronic skin condition characterized by patches of skin that appear red, scaly, or inflamed. If you are experiencing these symptoms, a previous diagnosis of psoriasis is indicative that psoriasis may have spread to your anal region as well. 

Symptoms of Perianal Dermatitis: 

Perianal dermatitis can have varying symptoms. Book your consultation at Dr. Maziar Ghodsian for an evaluation if you experience any of the following: 

  • Anal or rectal bleeding 
  • Anal pain/burning 
  • Pus, mucous, discharge or drainage 
  • Itchiness 
  • Thickening of the skin 
  • Redness around the anus 
  • Cracking or Fissuring (small cuts) on the perianal skin 

Pain is a common symptom associated with perianal dermatitis. It ranges from a sharp, stinging sensation lasting 2-3 hours after a bowel movement to chronic anal pain persisting for weeks or months. 

What treatments are used to treat perianal dermatitis? 

Treatments for perianal dermatitis include: 

  • Increasing water and dietary fiber intake to prevent constipation 
  • Stool softeners 
  • Dietary changes 
  • Pain relief medicines 
  • Topical medication 
  • Biopsy
  • Electrodesiccation 
  • Laser therapy 
  • Surgical drainage 

Most treatments for perianal dermatitis are nonsurgical. 

Call Dr. Maziar Ghodsian to inquire about the perianal dermatology services or schedule an appointment by completing the online booking feature today