Table 1.

Etiologies of pruritus ani

Anorectal disease	Anal fistula, fissure, skin tags, hemorrhoids, rectal prolapse, anal papillomas, rectal and anal carcinoma, fecal incontinence, hidradenitis
Systemic disease	Diabetes mellitus, chronic renal failure, iron deficiency, thyrotoxicosis, myxedema, Hodgkin’s lymphoma, jaundice, leukemia, aplastic anemia
Dermatologic conditions	Psoriasis, erythrasma, seborrheic dermatitis, atropic dematitis, intertrigo
Infections	Virus, bacteria, fungi, parasites
Gynecologic conditions	Vaginitis, endocervicitis
Neoplasms	Extramammary Paget’s disease, squamous cell carcinoma, cloacogenic carcinoma, Bowen’s disease
Hygiene	Poor cleansing or overaggressive cleansing with rubbing or excessive soap use
Diet	Coffee, chocolate, citrus, spicy foods, tea, beer, sodas containing caffeine, fat substitutes, milk and milk products
Local irritants	Obesity, excessive hair, tight-fitting clothing, anal creases, perfumed or dyed toilet paper, anal creams
Diarrheal states	Ulcerative colitis, crohn’s disease, irritable bowel syndrome
Radiation	Postirradiation changes
Psychogenic	Anxiety, neuroses, psychoses
Drugs: Idiopathic	Quinidine, colchicine, antibiotics, ointments that may contain alcohol