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]

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]

Genital Herpes

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. [ncbi.nlm.nih.gov]

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

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. [doi.org]

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

BACKGROUND: A risk associated with the iron chelator deferiprone is the development of neutropenia or agranulocytosis. Accordingly, the product label recommends weekly blood monitoring and immediate interruption of treatment upon detection of an absolute neutrophil count (ANC) PROCEDURE: This non-interventional[…] [ncbi.nlm.nih.gov]

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]

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]

Primary Genital Syphilis

Syphilis Listen Infection caused by bacteria. Syphilis is a sexually transmitted infection (STI). First, a sores appear on the sexual organs, in the mouth or anus, or between the buttocks. It is followed by a rash on the inside of the hands, feet and on the back. The doctor can cure syphilis with injections of[…] [zanzu.de]

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]

Amebiasis

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

ulceration •Cerebral amoebiasis [slideshare.net]

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

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]

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]

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]

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]

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]

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]

[…] symptoms: Migratory polyarthritis, sacroiliitis, ankylosing spondylitis, erythema nodosum, clubbing of fingertips, primary sclerosing cholangitis (not as common as with ulcerative [pathologyoutlines.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]