title: Management of idiopathic ulcer of the anal canal by excision in HIV-positive patients.
abstract: OBJECTIVE
  The aim of this article is to show our results from the surgical treatment of idiopathic anal ulcers.
  
  
  METHODS
  We present 33 patients with acquired immunodeficiency syndrome and idiopathic perianal ulcers. They presented with anal pain that failed to improve with medical treatment. Evaluation under anesthesia typically showed an irregular ulcer in the anal canal and an intersphincteric abscess. Surgical treatment consisted of an incision around the ulcer, its excision including margins but not its base, and abscess drainage.
  
  
  RESULTS
  All patients experienced significant immediate postoperative pain relief. Biopsies of the ulcer showed chronic inflammation, and no specific agents appeared in cultures.
  
  
  CONCLUSIONS
  These lesions seem to have the same cryptogenic origin as perianal abscesses, and we recommend surgical treatment to provide symptom relief.
authors.affiliation: Department of Proctology, The Emílio Ribas Infectious Diseases Institute, São Paulo, Brazil.
authors.forename: S R
authors.initials: SR
authors.lastname: Nadal
authors.forename: C R
authors.initials: CR
authors.lastname: Manzione
authors.forename: S H
authors.initials: SH
authors.lastname: Horta
authors.forename: V
authors.initials: V
authors.lastname: Galvão
mesh_terms: D000038:Abscess / Q000150:complications / Q000601:surgery; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D001004:Anus Diseases / Q000150:complications / Q000601:surgery; D001005:Anus Neoplasms / Q000175:diagnosis; D001706:Biopsy; D001913:Bowen's Disease / Q000175:diagnosis; D002278:Carcinoma in Situ / Q000175:diagnosis; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D002908:Chronic Disease; D003586:Cytomegalovirus Infections / Q000175:diagnosis; D004322:Drainage; D005260:Female; D005401:Fissure in Ano / Q000150:complications / Q000601:surgery* / Q000821:virology; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D008297:Male; D011349:Proctitis / Q000473:pathology; D014945:Wound Healing