R Al-Ghnaniem1, K Short2, A Pullen3, L C Fuller2, J A Rennie3, A J M Leather3. 1. Department of Surgery, King's College Hospital, Denmark Hill, London, SE5 9RS, UK. reyad@doctors.org.uk. 2. Department of Dermatology, King's College Hospital, London, UK. 3. Department of Surgery, King's College Hospital, Denmark Hill, London, SE5 9RS, UK.
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.
RCT Entities:
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.
Authors: J Lysy; M Sistiery-Ittah; Y Israelit; A Shmueli; N Strauss-Liviatan; V Mindrul; D Keret; E Goldin Journal: Gut Date: 2003-09 Impact factor: 23.059
Authors: A J Bircher; W Thürlimann; T Hunziker; F Pasche-Koo; N Hunziker; D Perrenoud; P Elsner; R Schultheiss Journal: Dermatology Date: 1995 Impact factor: 5.366