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1% Hydrocortisone ointment is an effective treatment of pruritus ani: a pilot randomized controlled crossover trial

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Abstract

Background

Pruritus ani (PA) is a common condition which is difficult to treat in the absence of obvious predisposing factors. There is paucity of evidence-based guidelines on the treatment of this condition. We examined whether 1% hydrocortisone ointment is an effective treatment for PA.

Materials and methods

A pilot randomized, double-blind, placebo-controlled, crossover trial was carried out. Eleven patients consented to take part in the trial and ten completed the study. After a 2-week run-in period, patients with primary PA were randomly allocated to receive 1% hydrocortisone ointment or placebo for 2 weeks followed by the opposite treatment for a further 2-week period. There was a washout period of 2 weeks between treatments. The primary outcome measure was reduction in itch using a visual analogue score (VAS). The secondary outcome measures were improvement in quality of life measured using a validated questionnaire (Dermatology Life Quality Index, DLQI) and improvement in clinical appearance of the perianal skin using the Eczema Area and Severity Index (EASI) score.

Results

Treatment with 1% hydrocortisone ointment resulted in a 68% reduction in VAS compared with placebo (P = 0.019), a 75% reduction in DLQI score (P = 0.067), and 81% reduction in EASI score (P = 0.01).

Conclusion

A short course of mild steroid ointment is an effective treatment for PA.

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Acknowledgment

This study was approved by the King’s College Hospital Ethics Committee. All costs of running the trial were paid for using departmental research funds. The authors have no conflict of interest to declare.

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Authors and Affiliations

  1. Department of Surgery, King’s College Hospital, Denmark Hill, London, SE5 9RS, UK

    R. Al-Ghnaniem, A. Pullen, J. A. Rennie & A. J. M. Leather

  2. Department of Dermatology, King’s College Hospital, London, UK

    K. Short & L. C. Fuller

Authors
  1. R. Al-Ghnaniem
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  2. K. Short
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  3. A. Pullen
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  4. L. C. Fuller
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  5. J. A. Rennie
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  6. A. J. M. Leather
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Corresponding author

Correspondence to R. Al-Ghnaniem.

Additional information

Previous publication: These data appeared in abstract form in Gastroenterology, 2003, 124(S1):A190 (abstract number S1295).

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Al-Ghnaniem, R., Short, K., Pullen, A. et al. 1% Hydrocortisone ointment is an effective treatment of pruritus ani: a pilot randomized controlled crossover trial. Int J Colorectal Dis 22, 1463–1467 (2007). https://doi.org/10.1007/s00384-007-0325-8

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  • DOI: https://doi.org/10.1007/s00384-007-0325-8

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