perianális

The perianal region refers to the skin and soft tissues surrounding the anus. It includes the perianal skin, the anal verge, and the adjacent subcutaneous tissues. The area is continuous with the perineum and buttock skin and is subject to dermatologic, infectious, inflammatory, and neoplastic processes.

Common problems in this region include dermatitis (irritant or allergic), anal fissures, perianal abscesses, fistulas, hemorrhoids, and perianal infections such as warts. Less frequently, cancers of the anal canal or perianal skin can occur, particularly in high-risk populations or in chronic disease.

Symptoms vary by condition but often include itching, pain, bleeding with defecation, swelling, discharge, or fever. Evaluation usually starts with a careful physical examination of the perianal skin and a digital rectal exam; imaging such as MRI or ultrasound is used selectively for suspected fistulas.

Management is condition-specific and emphasizes hygiene and symptom relief. Dermatitis is treated with barrier creams and avoiding irritants; fissures with laxatives, sitz baths, and topical agents; abscesses require drainage; fistulas may require surgery. Biopsy is indicated for suspicious or non-healing lesions.

Prevention focuses on good hygiene, avoiding irritants, and seeking prompt care for new or persistent lesions. Individuals with recurrent perianal problems, Crohn's disease, diabetes, immunosuppression, or a history of anal cancer should be evaluated by a clinician.