Table 2.
Consensual definitions and agreement scores
| Lesions and descriptors | Consensual definitions | Agreement scores1 |
| Ulceration | Skin or mucosal defect | 8.7 (8-9]3 |
| Depth | ||
| Superficial | Which is not deep | 8 (7-9)3 |
| Deep | Visible muscular and/or granulation tissue and/or undermined and inflammatory edges | 7.7 (7-9)3 |
| Cavitating | Deep decaying and destructive ulceration | 8.6 (8-9) |
| Localisation | ||
| Anal canal | Visible after unfolding the anus radial folds | 8.5 (7-9) |
| Anal margin | Anal external edges | 8.5 (7-9) |
| Perianal | Outside the anus radial folds | 9 |
| Extension | ||
| Number | 8.6 (8-9) | |
| Percentage of ulcerated area | < 25%, 26-50%, > 50% of the anal circumference | 8.3 (5-9) |
| Skin tag | Skin thickening of the anus | 7.2 (3-9) |
| Activity | ||
| Inflammatory | Oedematous, swollen, tense | 8 (4-9) |
| Non inflammatory | Fibrous, firm and non-oedematous aspect | 8.7 (2-9) |
| Ulcerated (vs not) | Ulceration on the skin tag (vs no ulceration on the skin tag) | 7.8 (2-9) |
| Perianal skin lesions | ||
| Papula | Elevated, circumscribed and solid lesion without liquid content | 8.1 (6-9) |
| Node2 | Elevated, nodular and protruding lesion, impression of deep extension | 7.8 (6-9) |
| Oedema | Swollen appearance | 8.2 (7-9) |
| Erythema | Flat redness | 8.3 (5-9) |
| Abscess | Swollen red skin, which may be surrounded by necrosis area and which can release pus | 8.3 (7-9) |
| Fistula | ||
| Complexity | AGA’s definitions (3) | |
| It is possible to recognize that a fistula is complex by inspection alone | 7.2 (1-9) | |
| Inspection alone is not always sufficient to reliably recognize that a fistula is simple | 8.5 (7-9) | |
| Drainage | ||
| Well drained | Absence of abscess, of purulent discharge an non inflammatory external opening(s) | 7.8 (5-9) |
| Poorly drained | Inflammatory external opening(s) and/or abscess and/or spontaneous purulent discharge | 7.5 (5-9) |
| Poor drainage of a fistula can be diagnosed by inspection alone | 8.6 (7-9) | |
| Inspection alone is often not sufficient to be certain that a fistula is well drained | 7.6 (1-9) | |
| External opening | ||
| Inflammatory | Erythematous surrounded skin and budding port(s) with undermined edges | Validated by vote 1 |
| Scar appearance | Deformed anus with fibrous aspect and/or retractile appearance of the anal margin | 7.6 (8-9) |
| With inflammatory activity or not | 7.6 (3-9) |
1
Median and distribution;
2
Validated by vote 1;
3
All definitions obtained a strong agreement except the entity “node”.