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The essentials of the treatment of pruritus ani consist of keeping the perianal skin scrupulously clean and dry. The most important damaging factors are fecal residue, moisture, scratching, steroids, and local anesthetics.
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The management of extramammary perianal Paget's disease should include a careful search for an associated carcinoma in the pelvic viscera by means of proctoscopy and x-ray. Such local malignancies as Bowen's disease, which may be pigmented and multifocal in this region, and invasive squamous cell carcinoma may first manifest themselves as pruritus ani.
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