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Journal of the Korean Society of... May 2023Perianal fistula is a common inflammatory condition in the general population and affects the area around the anal canal. Although most cases are benign, they cause... (Review)
Review
Perianal fistula is a common inflammatory condition in the general population and affects the area around the anal canal. Although most cases are benign, they cause serious morbidity and require surgical treatment due to a high risk of recurrence. MR imaging is a gold standard technique for the evaluation of perianal fistulas and provides accurate information on the anatomy of the anal canal, its relationship to the anal sphincter complex, accurate identification of secondary tracts or abscesses, and reporting associated complications. MR imaging can help monitor treatment effects and determine treatment methods. Crohn's disease-related fistulas often require medical rather than surgical treatment. The radiologist is required to know the anatomy and MR imaging findings of the perianal fistula to present an accurate diagnosis to the clinician.
PubMed: 37325009
DOI: 10.3348/jksr.2023.0018 -
Annals of Coloproctology Oct 2014The incidence of extramammary Paget's disease (EMPD) is very low. An 84-year-old Korean man was treated with topical and oral medications at a local dermatologic clinic...
The incidence of extramammary Paget's disease (EMPD) is very low. An 84-year-old Korean man was treated with topical and oral medications at a local dermatologic clinic for a year, but the symptoms did not improve. He visited Severance Hospital and underwent a perianal skin biopsy and was finally diagnosed with EMPD. The authors performed a wide local excision according to a 1-cm margin around the lesion. For the skin and the soft tissue defects, bilateral inferior gluteal artery perforator flap transpositions were performed. The size of the lesion was 14 cm(2) × 9 cm(2), and the lateral and the basal margins were all disease free.
PubMed: 25360433
DOI: 10.3393/ac.2014.30.5.241 -
Ugeskrift For Laeger Feb 2023A 34-year-old man, homosexual, came to the clinic of venerology due to severe perianal pain. When examinated, small, eroded vesicles were found perianally. This was...
A 34-year-old man, homosexual, came to the clinic of venerology due to severe perianal pain. When examinated, small, eroded vesicles were found perianally. This was interpreted as a primary herpes infection. At the follow-up visit, several vesicular and papular elements were now present on the body. The patient tested positive for mpox. This case confirms that mpox is a relevant differential diagnose in venerology in Denmark.
Topics: Male; Humans; Adult; Diagnosis, Differential; Mpox (monkeypox); Herpes Zoster; Dermatitis
PubMed: 36762374
DOI: No ID Found -
International Journal of Women's... Oct 2023
PubMed: 37576593
DOI: 10.1097/JW9.0000000000000103 -
Frontiers in Surgery 2022
PubMed: 35836609
DOI: 10.3389/fsurg.2022.952874 -
Clinical Gastroenterology and... Jun 2024Perianal fistulizing Crohn's disease (PFCD)-associated anorectal and fistula cancers are rare but often devastating diagnoses. However, given the low incidence and... (Review)
Review
BACKGROUND AND AIMS
Perianal fistulizing Crohn's disease (PFCD)-associated anorectal and fistula cancers are rare but often devastating diagnoses. However, given the low incidence and consequent lack of data and clinical trials in the field, there is little to no guidance on screening and management of these cancers. To inform clinical practice, we developed consensus guidelines on PFCD-associated anorectal and fistula cancers by multidisciplinary experts from the international TOpClass consortium.
METHODS
We conducted a systematic review by standard methodology, using the Newcastle-Ottawa Scale quality assessment tool. We subsequently developed consensus statements using a Delphi consensus approach.
RESULTS
Of 561 articles identified, 110 were eligible, and 76 articles were included. The overall quality of evidence was low. The TOpClass consortium reached consensus on six structured statements addressing screening, risk assessment, and management of PFCD-associated anorectal and fistula cancers. Patients with longstanding (>10 years) PFCD should be considered at small but increased risk of developing perianal cancer, including squamous cell carcinoma of the anus(SCCA) and anorectal carcinoma. Risk factors for SCCA, notably human papilloma virus (HPV), should be considered. New, refractory, or progressive perianal symptoms should prompt evaluation for fistula cancer. There was no consensus on timing or frequency of screening in patients with asymptomatic perianal fistula. Multiple modalities may be required for diagnosis, including an exam under anesthesia (EUA) with biopsy. Multidisciplinary team efforts were deemed central to the management of fistula cancers.
CONCLUSION
Inflammatory bowel disease (IBD) clinicians should be aware of the risk of PFCD-associated anorectal and fistula cancers in all patients with PFCD. The TOpClass consortium consensus statements outlined herein offer guidance in managing this challenging scenario.
PubMed: 38871152
DOI: 10.1016/j.cgh.2024.05.029 -
World Journal of Gastrointestinal... Mar 2024Anal pruritus is a common anorectal symptom that can significantly impair a patient's quality of life, including their mental health. It can be one of the most difficult...
Anal pruritus is a common anorectal symptom that can significantly impair a patient's quality of life, including their mental health. It can be one of the most difficult proctological conditions to treat. Patients often delay seeking medical attention, since it is an embarrassing but non-life-threatening situation. Pruritus ani can be associated with idiopathic and secondary causes, such as anorectal diseases, cancer (anal or colorectal), dermatological and sexually transmitted diseases, fungal infections and systemic diseases. If patients are referred for a colonoscopy, this can sometimes provide the first opportunity to evaluate the perianal area. Classifications of anal pruritus are based on the abnormalities of the perianal skin, one of the most commonly used being the Washington classification. A proper digital anorectal examination is important, as well as an anoscopy to help to exclude anorectal diseases or suspicious masses. Endoscopists should be aware of the common etiologies, and classification of the perianal area abnormalities should be provided in the colonoscopy report. Information on treatment possibilities and follow-up can also be provided. The treatment normally consists of a triple approach: proper hygiene, elimination of irritants, and skin care and protection. Several topical therapies have been described as possible treatments, including steroids, capsaicin, tacrolimus and methylene blue intradermal injections.
PubMed: 38577644
DOI: 10.4253/wjge.v16.i3.112 -
JAAD Case Reports Mar 2022
PubMed: 35242960
DOI: 10.1016/j.jdcr.2021.09.046