Perianal Ulcer: Causes & Reasons

Possible Causes for Perianal Ulcer

Sexually Transmitted Disease Treatment Guidelines: Diseases Characterized by Genital, Anal, or Perianal Ulcers. [labtestsonline.it]

Progressive and persistent esophagitis, colitis, perianal ulcers, pneumonia, encephalitis, and meningitis may occur. [merckmanuals.com]

Lymphogranuloma Venereum

Two cases of HIV-infected patients presenting with isolated perianal ulcer disease are reported here. [ncbi.nlm.nih.gov]

We report a white bisexual male who presented with a painful perianal ulcer, inguinal lymphadenitis, and concomitant infection with human immunodeficiency virus 1 (HIV-1). [ncbi.nlm.nih.gov]

Persistent perianal or genital ulcer was also reported [ 4, 5 ]. [omicsonline.org]

Genital Herpes in Women

Sexually Transmitted Disease Treatment Guidelines: Diseases Characterized by Genital, Anal, or Perianal Ulcers. [labtestsonline.it]

A visible outbreak consists of single or clustered vesicles on the genitalia, perineum, buttocks, upper thighs, or perianal areas that ulcerate before resolving. [aafp.org]

[…] areas that ulcerate before resolving. [aafp.org]

Inflammatory Bowel Disease Type 1

Penetrating: Crohn’s causes fistulas, perianal ulcers, inflammatory masses, or abscesses Uncomplicated What Can I do to Manage Crohn's Disease? [webmd.com]

CD may involve any or all parts of the entire GI tract from mouth to perianal area, although it is usually seen in the terminal ileal and perianal locations. [bestpractice.bmj.com]

Unlike ulcerative colitis (UC), CD is characterised by skip lesions (where normal bowel mucosa is found between diseased areas). [bestpractice.bmj.com]

Primary HIV Infection

Consider the diagnosis in patients presenting with a blotchy rash on the trunk or oral or perianal ulcers. [patient.info]

Aphthous ulcers are shallow and painful and usually affect the posterior oropharynx. [reference.medscape.com]

Lesions from herpes simplex virus (HSV) may be present; oral and genital lesions are most common, but perianal and periungual lesions are also observed. [reference.medscape.com]

Genital Herpes

A visible outbreak consists of single or clustered vesicles on the genitalia, perineum, buttocks, upper thighs, or perianal areas that ulcerate before resolving. [ncbi.nlm.nih.gov]

Sexually Transmitted Disease Treatment Guidelines: Diseases Characterized by Genital, Anal, or Perianal Ulcers. [labtestsonline.it]

[…] areas that ulcerate before resolving. [aafp.org]

Pediatric Crohn Disease

Sixty (18.2%) patients had perianal involvement, ranging from isolated skin tags to severe perianal ulceration and fistulae. [hindawi.com]

Although perianal ulcers were included in the definition, postoperative intraabdominal complications and perianal skin tags were excluded. [oadoi.org]

In addition, Crohn disease attacks the perianal tissues more often than does ulcerative colitis. [britannica.com]

Primary Syphilis

Diseases Characterized by Genital, Anal, or Perianal Ulcers. Available online at http://www.cdc.gov/std/treatment/2010/genital-ulcers.htm. Accessed January 2013. [labtestsonline.org]

Signs Solitary Chancre (hallmark of Primary Syphilis) Painless Papule ulcerates Indurated lesion with smooth base and firm border Chancre distribution Forms a Genital Ulcer [fpnotebook.com]

[…] in nearly all cases (may form on Cervix or perianally) May be difficult to visualize Men and women Carefully examine the perianal area Women Use a speculum and examine the [fpnotebook.com]

Acquired Immunodeficiency Syndrome

Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions. N Engl J Med 1981;305:1439-44. [cdc.gov]

Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions. N Engl J Med. 1981;305(24):1439–44. [springerlink.com]

ulcerative herpes simplex lesions. [retrovirology.com]

Behçet Disease

Groin, perianal, and perineal ulcers occur in both sexes.29 Ocular disease Eye involvement occurs in 30%–70% of patients with Behçet’s disease, and it is more common and more [dovepress.com]

Ulcer shapes, distributions, numbers, margins, and border contours, and the presence of aphthous, cobblestone, perianal, and strictured lesions were compared, in the training [dx.doi.org]

In female patients, ulcers occur on the vulva, vagina, and cervix and may cause dyspareunia. [dovepress.com]

Agranulocytosis

Endocrine Abstracts (2003) 5 P27 Department of Endocrinology, Countess of Chester Hospital NHS Trust, Chester, UK Agranulocytosis is a well recognised but rare side effect of carbimazole therapy which usually occurs within the first 3 months of treatment .We report the case of a 55 year old woman with Graves[…] [endocrine-abstracts.org]

Acute Radiation Sickness

Biosecur Bioterror. 2011 Dec;9(4):345-50. doi: 10.1089/bsp.2011.0042. Epub 2011 Oct 11. Author information 1 Center for Biosecurity of UPMC, Baltimore, Maryland 21202, USA. aadalja@biosecurity-upmc.org Abstract After the detonation of an improvised nuclear device, several key actions will be necessary to save the[…] [ncbi.nlm.nih.gov]

Amoebiasis due to Entamoeba histolytica

Colonic manifestations comprise a spectrum of disease, including 1-2 : acute proctocolitis (dysentery) perianal ulceration fulminant colitis leading to colonic wall perforation [radiopaedia.org]

Potential unusual manifestations of amebic colitis include ameboma, toxic megacolon, acute necrotizing colitis, cutaneous amebiasis, and perianal ulcerations (with fistula [news-medical.net]

Intestinal amoebiasis may rarely be complicated by: granuloma of the large intestine colitis, colonic perforation and haemorrhage perianal ulceration. [www2.health.vic.gov.au]

Gonococcal Proctitis

HIV Infection Persons with HIV infection and acute proctitis may present with bloody discharge, painful perianal ulcers, or mucosal ulcers. [cdc.gov]

8 It may present with perianal ulceration, fistulation, segmental colitis and abdominal pain. [fg.bmj.com]

Those due to STI’s may show perianal or rectal ulcers, chancres, condyloma, or tender inguinal lymphadenopathy. [statpearls.com]

Acute Amebic Dysentery

Colonic manifestations comprise a spectrum of disease, including 1-2 : acute proctocolitis (dysentery) perianal ulceration fulminant colitis leading to colonic wall perforation [radiopaedia.org]

Intestinal amoebiasis may rarely be complicated by: granuloma of the large intestine colitis, colonic perforation and haemorrhage perianal ulceration. [www2.health.vic.gov.au]

ulceration with fistula formation. [histopathology-india.net]

Amebiasis

We describe this infestation in a 9-year-old Mexican immigrant who presented with diarrhea and perianal ulcers. [ncbi.nlm.nih.gov]

Intestinal amoebiasis may rarely be complicated by: granuloma of the large intestine colitis, colonic perforation and haemorrhage perianal ulceration. [www2.health.vic.gov.au]

Rarely, ulceration in the perianal region can occur as a direct extension from intestinal lesions, and penile lesions may occur in men who have sex with men. [www2.health.vic.gov.au]

Primary Genital Syphilis

Home References Syphilis is caused by Treponema pallidum, a spiral-shaped bacterium. (Image: © CDC) Syphilis is a sexually transmitted disease that is caused by the bacterium Treponema pallidum. After chlamydia and gonorrhea, it is the third most common sexually transmitted disease reported to the U.S. government,[…] [livescience.com]

Genital Ulcer

Less common infectious causes of genital, anal, or perianal ulcers include chancroid and donovanosis. [cdc.gov]

Genital herpes treatment, WebMD Diseases Characterized by Genital, Anal, or Perianal Ulcers, Centers for Disease Control and Prevention [en.wikipedia.org]

Two biopsies from the perianal ulcers showed inflamed squamous papillomata with no Donovan bodies. [mdedge.com]

Basaloid Anal Carcinoma

Indurated, ulcerated lesion with irregular borders Microscopic (histologic) description Resembles basal cell carcinoma at other sites (see Skin nonmelanocytic chapter) Retraction [pathologyoutlines.com]

1999;42:1200) Case reports 69 year old man with perianal basal cell carcinoma (Indian J Dermatol 2010;55:178) 88 year old woman with polypoid basal cell carcinoma on the perianal [pathologyoutlines.com]

[…] region (J Dermatol 2004;31:51) Treatment Wide local excision with negative margins Clinical images Images hosted on other servers: Perianal basal cell carcinoma Gross description [pathologyoutlines.com]

Proctitis

HIV Infection Persons with HIV infection and acute proctitis may present with bloody discharge, painful perianal ulcers, or mucosal ulcers. [cdc.gov]

If painful perianal ulcers are present or mucosal ulcers are detected on anoscopy, presumptive therapy should also include a regimen for genital herpes (see Genital Herpes [cdc.gov]

While painful perianal ulcers can be indicative of HSV, HSV proctitis is often not associated with the presence of visible ulcers. [mshc.org.au]

Anal Buschke-Lowenstein Tumor

[…] fistula, ulcerative colitis) Poor hygiene Cases in children raise the suspicion of sexual abuse, though this association is not well established (Am J Dis Child 1982;136: [pathologyoutlines.com]

[…] for six months due to a large perianal ulcerated lesion. [wjso.biomedcentral.com]

[…] exophytic and cauliflower-like mass with or without abscess, fistula, pain, pruritus, bleeding and ulceration Slow growing, local extension Usually no perineural invasion [pathologyoutlines.com]

Amyotrophic Lateral Sclerosis Type 8

ulceration •Cerebral amoebiasis [slideshare.net]

Intestinal amoebiasis may rarely be complicated by: granuloma of the large intestine colitis, colonic perforation and haemorrhage perianal ulceration. [www2.health.vic.gov.au]

Unusual but serious complications such as fulminant necrotizing colitis, toxic megacolon, and fistulizing perianal ulcerations can occur, especially when diagnosis and treatment [hindawi.com]

Buschke-Lowenstein Tumor

Chronic irritation, produced by a perianal fistula and ulcerative colitis, has been implicated as a causative factor. [5.102.145.157]

[…] due to a large perianal ulcerated lesion. [wjso.biomedcentral.com]

Verrucous Vulvar Carcinoma

The lesion did not infiltrate the vaginal mucosa, fourchette, or perianal region/anus. [ncbi.nlm.nih.gov]

Lesion surface was ulcerated with bleeding and pain to the touch and signals of local infection (Figure 1). [ncbi.nlm.nih.gov]

Amebic Lung Abscess

Potential unusual manifestations of amebic colitis include ameboma, toxic megacolon, acute necrotizing colitis, cutaneous amebiasis, and perianal ulcerations (with fistula [news-medical.net]

ulceration with fistula formation. [histopathology-india.net]

Meningoencephalitis Intestinal diseases in Entamoeba Histolytica Infection: 1)Asymptomatic 2) Dysentery 3) Acute necrotizing colitis with perforation 4)Toxic megacolon 5) Ameboma 6) Perianal [histopathology-india.net]

Chancroid of the Vulva

[…] with ragged undermined edges typically occur on the vulva and, less commonly, on the cervix Similar ulcers may occur perianally in men engaging in receptive anal intercourse [sti.guidelines.org.au]

All 14 women had ulcers; two (14%) had asymptomatic cervical ulcers that were found only on examination; six (43%) had only perianal ulcers; and the remaining six (43%) had [cdc.gov]

Similar ulcers may occur extremely rarely perianally in women engaging in receptive anal intercourse Extragenital lesions (e.g. fingers) may occur as a result of accidental [sti.guidelines.org.au]

Semmekrot-Haraldsson-Weemaes Syndrome

A Dutchman from Mali with a perianal ulcer caused by cutaneous amoebiasis. Abstract. [biosciences.exeter.ac.uk]

A Dutchman from Mali with a perianal ulcer caused by cutaneous amoebiasis. Abstract. Warris A, Verweij PE (2005). [biosciences.exeter.ac.uk]

[A Dutchman from Mali with a perianal ulcer caused by cutaneous amoebiasis]. Ned Tijdschr Geneeskd, 149(6), 308-311. Abstract. [biosciences.exeter.ac.uk]

Ileal Crohn Disease

Penetrating: Crohn’s causes fistulas, perianal ulcers, inflammatory masses, or abscesses Uncomplicated What can I do to manage Crohn's disease? [webmd.com]

Rectal bleeding is not typically present in Crohn's disease, but abscesses, fistulas, perianal ulcerations, and narrowing of the intestinal lumen are common sequelae. [medical-dictionary.thefreedictionary.com]

Inspection of the perianal region can reveal skin tags, fistulae, ulcers, abscesses, and scarring. [emedicine.medscape.com]

Penile Chancroid

Non-HSV perianal ulcerations 1.Viral -CMV 2. [dermcast.tv]

All 14 women had ulcers; two (14%) had asymptomatic cervical ulcers that were found only on examination; six (43%) had only perianal ulcers; and the remaining six (43%) had [cdc.gov]

Generalized Herpes Simplex

Progressive and persistent esophagitis, colitis, perianal ulcers, pneumonia, encephalitis, and meningitis may occur. [msdmanuals.com]

These patients can present with extensive oral or perianal ulcers, meningoencephalitis, esophagitis, colitis, chorioretinitis, tracheobronchitis, pneumonia, and acute retinal [clinicaladvisor.com]

Herpes simplex virus type 2 is the most common cause of genital ulcers worldwide, and it is typically characterized by local eruptions manifesting as painful genital or perianal [academic.oup.com]