. Diseases of the rectum and anus: designed for students and practitioners of medicine. on anerve or its terminal filaments, there are no external evidencesof the condition; but, as it progresses, the usual irritation ofthe skin induced by scratching will become manifest. In theearlier stages of pruritus ani due to ulceration of either malig-nant, specific, or other nature, or to disease accompanied by PRURITUS ANI 193 a discharge, the skin and anal mucous membrane appear moist,somewhat reddened, and sometimes swollen and tender to thetouch. Later on, because of the continued irritation by the
. Diseases of the rectum and anus: designed for students and practitioners of medicine. on anerve or its terminal filaments, there are no external evidencesof the condition; but, as it progresses, the usual irritation ofthe skin induced by scratching will become manifest. In theearlier stages of pruritus ani due to ulceration of either malig-nant, specific, or other nature, or to disease accompanied by PRURITUS ANI 193 a discharge, the skin and anal mucous membrane appear moist,somewhat reddened, and sometimes swollen and tender to thetouch. Later on, because of the continued irritation by theacrid discharge and the coincident scratching, excoriation ofthe parts becomes noticeable, and a type of subacute inflam-mation is excited in the radiating folds of skin about the anus,and these become swollen and sometimes edematous. If thedischarge be not now arrested, and the parts not kept clean,it cohects between the swollen, radiating folds and decomposes,causing increased irritation and an extension of the inflamma-tion; the skin then becomes thickened, less mobile, and has a. Fig. 53.—Eczema Marginatum. doughy feel. During this time, as a result of gradual exfolia-tion of the epithelium, the skin loses its pigment and assumesa dead-zvhite hue: the typic parchment-like appearance so fre-quently described. Finally, the affected area may include theentire ano-gluteal region; hypertrophic changes may occur inthe skin, and cauliflower-like excrescences may spring up, oreczema or erythema may be induced. In the majority of cases,however, the skin becomes rigid, thickened, harsh, white, andglistening. The radiating folds of skin become enlarged, elon-gated, and more prominent, and appear like long rays extend-ing out from the anus in every direction. The terminal nerve- 194 DISEASES OF THE RECTUM AND ANUS filaments are destroyed or compressed as a result of the inflam-mation and induration, and consequently there is diminishedsensibility. The cutaneous blood-vessels are also
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanusdis, bookyear1910
