Introduction
Anal eczema is an inflammation of the skin on the anus, doctors speak of dermatitis of the anoderma (inflammation of the anus). Anal eczema is relatively common. Affected patients should therefore not be ashamed to consult a doctor to treat the symptoms. Anal eczema is in most cases a consequence of various other diseases and can be acute (sudden) or chronic (protracted).
Classification of anal eczema
The anal eczema can be classified according to various aspects. According to the time course, it is classified as acute, sub-acute (relatively sudden) or chronic anal eczema. A classification according to the causes is also possible and useful. There are the irritative-toxic, the atopic (atopy denotes the tendency to hypersensitivity reactions) and the contact-allergic anal eczema. In chronic anal eczema several causes usually play a role.
Symptoms of anal eczema
The main symptom of anal eczema is also the worst for the patient: very severe itching, which doctors call pruritus ani, or anal itching. The skin on the anus is reddened over the entire surface, depending on the cause of the anal eczema, a reddening with sharp or blurred boundaries occurs. A further symptom is weeping of the anus, which softens the skin.
The softening can lead to whitish discoloration in the anal eczema area. In chronic anal eczema, erosions and cracks of the skin, so-called rhagades, are also common. The most frequent bleeding of the intestine and anal area is caused by haemorrhoids, tears in the mucous membrane of the anus, inflammation of the rectum or intestinal cancer.
Blood in the anus does not always have to be caused by a malignant disease. Anal eczema can also be caused by blood on the anus, which can tear the inflammatory skin and bleed. The blood can also be deposited in the bowel movement. If the bleeding was caused by anal eczema, the bleeding should disappear with therapy.
Diagnostics
In order to diagnose anal eczema, the doctor will ask you to undress underneath and lie on an examination couch with your legs bent. In most cases, anal eczema provides a clear picture for the examining doctor. An anal eczema with blurred edges is more likely to have an irritative-toxic cause, an anal eczema with sharp edges is more likely to have an allergic contact eczema.
In some cases it may be necessary to take a smear to exclude a fungal disease. It may also be necessary to take a small sample to perform a microscopic examination of the tissue. Through the microscope other diseases can be confirmed or excluded, which can look very similar to anal eczema: The anal carcinoma, the psoriasis of the anal fold and other, rarer skin diseases. In many cases haemorrhoids are one of the causes of anal eczema. If the doctor finds haemorrhoids in you, a proctological examination of the rectum will be necessary.
