[Topical therapy of perianal eczema]

Perianal eczema is a common diagnosis in patients seeking help from a proctologist/dermatologist. Due to their different etiology, perianal eczemas can be subdivided into irritant-toxic, atopic, and contact allergic forms. While these three entities may present with a similar clinical picture, the correct differential diagnosis is crucial for rapid successful therapy. After treatment of any underlying proctologic disease, low-potency corticosteroid or calcineurin inhibitor formulations may be applied for short-term topical perianal therapy. Preparations containing zinc oxide and cleaning of the perianal region with clear water can support the healing process. Patients should avoid topical irritants and potential contact allergens. Perianal eczema resistant to therapy should be further evaluated by histopathological workup to exclude precancerous or malignant skin disease.