Division of Dermatology, University of Massachusetts Medical School, Worcester, MA, USA.
Dermatitis. 2011 Jan-Feb;22(1):50-5.
Pruritus ani is a common distressing problem with numerous possible causes. When locally applied agents trigger irritation or allergic response, skin changes of dermatitis usually accompany the itch. Focal pruritus in the absence of dermatitis is not generally considered to be a manifestation of contact allergy. Furthermore, focal pruritus is not listed among the possible diverse presentations of the systemic delivery of a proven contact allergen. We report a case of a gentleman with a 1.5-year history of treatment-resistant pruritus ani. When patch testing revealed a positive reaction to nickel sulfate, he admitted to daily peanut butter consumption. His symptoms resolved with dietary nickel restriction. Patch testing may be useful in patients with pruritus of the anogenital region, not only to elucidate potential contact exposures contributing to the symptom but also to suggest possible dietary precipitants.
肛门瘙痒是一种常见的令人痛苦的问题，可能有多种原因。当局部应用的药物引起刺激或过敏反应时，通常伴有皮炎样的皮肤变化。没有皮炎的局部瘙痒一般不被认为是接触过敏的表现。此外，局部瘙痒也没有被列入已知接触过敏原全身输送的可能的多种表现形式之一。我们报告了一例 1.5 年治疗无效的肛门瘙痒男性患者。斑贴试验显示对硫酸镍呈阳性反应，他承认每天食用花生酱。限制饮食中的镍含量后，他的症状得到缓解。斑贴试验可能对会阴部瘙痒的患者有用，不仅可以阐明导致症状的潜在接触暴露，还可以提示可能的饮食诱因。
