Perianal eczema

Eczematous dermatitis in the region of the anus.

Irritant-toxic: e.g. in anal incontinence

Atopic: in patients with atopy, e.g. also in the context of atopic dermatitis

Contact allergic: with the application of various creams or also with the application of moist toilet paper (wipes)

In some cases, a Candida infection can also develop secondarily.

The symptoms of Candida can be very severe

Pruriginous, erythematous, sometimes confluent erythematous papules perianally.

Clinic

Around the anus

Spongiotic dermatitis, as in other eczemas.

Bacterial or mycological superinfection.

Avoid the trigger if possible.

Steroid-containing ointment, class II / III (Emovate, Elocom ointment)

• Always use ointment not cream.

Alternatively, calcineurin inhibitors can be used:

• Pimecrolimus (Elidel)
• Tacrolimus (Protopic)

Sometimes application with tar-containing products is recommended, e.g. Liquor carbonis detergens in Ungentum leniens.

1. Schauber J, Weisenseel P, Ruzicka T. Topical treatment of perianal eczema with tacrolimus 0.1%. Br J Dermatol. 2009 Dec;161(6):1384-6.
2. Weyandt G, Breitkopf C, Werner RN, Zidane M, Furtwängler A, Jongen J, Rothhaar A, Schaefer D, Lenhard B. German S1 guidelines for the diagnosis and treatment of perianal dermatitis (anal eczema). J Dtsch Dermatol Ges. 2020 Jun;18(6):648-657.