title: Intra-dermal methylene blue, hydrocortisone and lignocaine for chronic, intractable pruritus ani.
abstract: OBJECTIVE: To assess the use of intradermal methylene blue, lignocaine and hydrocortisone in cases of chronic pruritus ani refractory to standard primary, dermatological and colorectal care. METHODS: Five ml 1% methylene blue, 100 mg hydrocortisone and 15 ml 1% lignocaine were injected into the peri-anal skin of 25 patients with chronic pruritus ani which had proved refractory to standard care. Clinical and telephone follow-up was undertaken. RESULTS: After one injection of the above solution, 16 (64%) of patients were rendered symptom free. Repeat injection in those initial nonresponders ultimately rendered 22 (88%) symptom free overall. Morbidity was 4%. Treatment failure occurred in three patients (12%). CONCLUSIONS: Methylene blue used in solution with hydrocortisone and lignocaine can achieve effective control of pruritus ani in 88% of patients who have failed to respond to standard dermatological, hygiene and surgical treatments.
authors.affiliation: Department of General Surgery, The General Infirmary, Leeds, LS1 3EX, UK.
authors.forename: I. D
authors.initials: ID
authors.lastname: Botterill
authors.forename: P. M
authors.initials: PM
authors.lastname: Sagar