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Anal spots and itching

Resolved Question:

Hi Doctor,
i am 33 years old male,
10 days ago i started having anal itching, i checked with a mirror to find 2 spots around the anus with raw skin red they didnt hurt to touch or press them, 2 days after the itching became stronger , its a constant itching through the day, there is no pain while having a bowel movement , and the bowel is so normal in shap and color and habbit, the itch may start to be worse sometime after the bowel movement, there is no blood or any discharge.

i visited a colorectal surgion who listened to my complains and then checked the area and did a Digital rectal exam, he touched around the anus and asked if i have any pain (none) and asked me to contract my anus muscle on his finger and push , after that exam he said there is no hemorrhoids,fissures or anything in the rectum and said this is likely a worm infection in the stool , he asked for a stool test which came negative, he prescribed Flagyl and asked me to have 3 salt sitz bath daily, i felt the salt sitz bath made the itching very bad, and i used betadine drops instead , also the flagyl gave me a terrible side effects and i had to stop it.

i really cant understand if the stool test came negative why would i continue havnig a medication for stomach infection,

lately the itching moved more inside the anus , its like something is eating the wall of it, i feel ok when standing or laying down, but the sitting is very bad at times.

i underwent a VAT bullectomy on the left lung 2.5 months ago, and so was on antibiotics for some time, but there is a large gap of time between the last antibiotics and the itching (like 1.5 months)

i was stressed before this happens and i am more stressed now not knowing whats wrong, i am so afraid this could be rectal cancer although the doctor said there is nothing after the DRE and he doesnt seems worried at all

i really need a second opinion , is this normal?


Category: Dermatologist

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Category: Cosmetic and Plastic Surgeon
Dr. Kruti Jobanputra Banodkar is online now

Expert:  Dr. Kruti Jobanputra Banodkar replied 4 Days.

Hello

Thanks for posting your query.

I can understand your concern.

Anal itching at times can be without any cause. And this itching itself can lead on to aberration. Since everything has been examined and any possibility of any condition has been ruled out, it's unlikely that there is anything physically inside the anal canal.

You mentioned two spots around the anus, you could send me a picture of that.

Meanwhile you can start taking an anti histamine like claritin at night.

If claritin doesn't work in the next five days, then you could consider taking a second opinion.

Application of cortisone cream around the anal area will also help to relieve the itching and will take of the condition in most of the cases.

Another cause as your MD rightly suspected in a worm infestation. (Enterobious ). In many cases the stool test will not show any result. However Albendazole or Mebandazole is the best treatment option (not flagyl). You should discuss this with your GP and consider taking a single dose of Albendazole.

Please let me know if you have any queries.

Take care


Patient replied :

Hi doctor thanks for your reply here is the photo of the red areas around anus you requested


Expert:  Dr. Kruti Jobanputra Banodkar replied 3 Days.

Hello

Thanks for your reply and the picture.

There seems to be some redness, a fissure and a bacterial infection of the hair follicle which is seen in the form of a pits filled boil.

I would recommend application of a moisturizer and also a mixture of cortisone and neosporin cream on the area.

This might help in resolving the itching.


Please let me know if you have any queries.

Take care


Patient replied :

Thanks doctor, sorry but final question, i visited my doctor again today for followup, he changed me to ciprofloxacin 750 mg twice a day and also a xylocaine jelly 2% (lidocaine hydrochloride) , he said that i am very stressed with the issue and so my mind is locked down there and so i am not feeling any better because i am over worried about it and so he gave me Dogmatil 50 to keep me calm , when i was on the drug store i asked for the Albendazole as you said and bought one pack to be taken for 3 days, do you think i can take the Albendazole with the Cipro or may be try the Albendazole first for 3 days then start taking the Cipro if it didnt work?, also is this Xylocaine helly helpfull for this skin issues?

Thanks


Expert:  Dr. Kruti Jobanputra Banodkar replied 2 Days.

Hello,

I really cannot comment on this, as you are also taking medication under care of a Doctor. You should discuss this with your Doctor (regarding Albendazole). Generally both can be taken together under the care of your Doctor. Lignocaine jelly is helpful in reducing symptoms.

Thank you


Dr. Kruti Jobanputra Banodkar
Category: Cosmetic and Plastic Surgeon
Experience: 
Diploma in Dermatology - Royal College Of Physicians & Surgeons Of Glasgow, UK , 2010
Residency - DNB, Dermatology -  K.J Somaiya Hospital, Mumbai, 2009
Medical School & Internship - MBBS - Dr. D . Y . Patil Medical College, Mumbai, 2004
Dr. Kruti Jobanputra Banodkar and 4 other Medical Specialists are ready to help you

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