Abstract
Perianal skin is subject to virtually all of the diseases that affect skin and mucosa. The differential diagnosis of disease in perianal skin is broad (Table 16-1) and includes a variety of diagnoses. These diseases almost never present solely within the perianal area; however, there are common diseases such as psoriasis that may present in the perianal area without obvious ties to other areas of the body unless a careful search is made. Certain diseases have specific causes and well-recognized treatment protocols (e.g., psoriasis, candida, and Bowen’s disease), other diseases have less well-defined causes and all too often where therapy is established it is poorly defined. Recognition of important treatable causes requires a disciplined, organized approach to diagnosis with careful and complete history, physical exam, and the frequent use of biopsy. This chapter’s objective is to lay out a strategy to facilitate accurate diagnosis and successful treatment of perianal and anal skin conditions.
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