Pruritus Ani

Bodkin, American Journal of Digestive Diseases (1945),25 described the successful treatment of forty-one of forty-two cases of pruritus ani upon the addition of PHT to oral therapy. In this series of forty-two cases, only one showed no improvement and another recovered rather slowly. Almost all of the others responded in a surprisingly short time. The author stated that, "Pruritus ani has always been a difficult and baffling problem to the proctologist . . . It is notable for its chronicity and resistance to treatment. No one form of therapy has been effective, as is evidenced by the lengthy list of measures employed. It is therefore most interesting to come upon a method of treatment, mainly oral, that gives prompt symptomatic relief and which produces clearly visible results in the skin. It is aimed at the most likely site of origin of the condition - the nervous system . . . The one definite and positive finding that stood out in all the cases that I have carefully studied for the past ten years or more was this: every one of them was highly nervous." The duration of the symptoms in the group studied was from one to thirty years and included three cases that also had pruritus vulvae. The author had previously used takadiastase, novatropin and phenobarbital. When PHT was added, the results were rather striking. Even long standing cases obtained marked symptomatic relief within a few days.

25. Bodkin, L. G., Oral therapy for pruritus ani, Amer. J. Dig. Dis., 12: 255-257, 1945.

Goodwin, Journal of the National Proctologic Association (1946),127 described the successful treatment of twenty cases of pruritus ani treated with PHT and a starch digestant. The results obtained were superior to any therapy previously employed. The author stated that this study confirmed the work of Bodkin.25 Length of treatment varied. Usually the physical signs of bleeding, maceration, leathery appearance, moist skin, fissures, cracked skin and itching began to disappear from one to three weeks after institution of therapy. The patients usually volunteered before they were examined that they were much better after two or three weeks' treatment. One severe case of pruritus was observed in which there was extensive maceration and bleeding of the anus, scrotum and groin. So intense was the pruritus that nothing seemed of value in bringing even temporary relief. With PHT and a starch digestant, the patient showed marked improvement to the point that treatment was discontinued at the end of six weeks. Recurrence was observed in one patient. Reestablishing treatment effected prompt relief. In the author's experience the rapid relief of symptoms achieved with PHT had not been obtained with the use of any local treatment.

127. Goodwin, F. B., Oral therapy in anogenital pruritus, J. Nat. Proct. Assn., 18: 84-87, 1946.
25. Bodkin, L. G., Oral therapy for pruritus ani, Amer. J. Dig. Dis., 12: 255-257, 1945.

Bodkin, American Journal of Digestive Diseases (1947),26 in an expanded series of 111 cases of pruritus ani, again reported excellent results with PHT. Of the 111 cases treated, only six failed to respond. Five patients discontinued medication and their outcome was unknown. The author stated that it was a pleasant surprise to find that recurrences were not too numerous and that they were rather easily controlled by reinstitution of PHT.

26. Bodkin, L. G., Pruritus ani: a review of oral therapy, Amer. Dig. Dis., 14: 109-113, 1947.