Perianal streptococcal dermatitis: causes, symptoms, diagnosis, and treatment

Perianal streptococcal dermatitis (PSD) is a superficial inflammation of the perianal skin.


Causes

Perianal streptococcal dermatitis is caused mostly by group A ß hemolytic streptococcus, merely by staphylococcus aureus, mostly in children aged 6 months to 10 years


Signs and Symptoms

Perianal streptococcal dermatitis is clinically manifested by sharply demarcated bright red erythema around the anus, sometimes with white exudate, pseudomembranes, fissures or cracks in the skin lesions. Skin and mucous membranes of external genitalia can be invaded. Subjective pruritus, tenderness, blood-streaked stools, and pain during defecation are present. Fever, malaise or other systemic symptoms are absent. Subcutaneous involvement of cellulitis is absent.


Diagnosis

On the basis of typical clinical presentations and results of culture of anal, perianal, and perineal swabs, a definitive diagnosis can provided.


Treatment

Treatment regimen is systemic penicillin or erythromycin for 14 - 21 days, oral amoxicillin for 10 days, or topical 2% mupirocin ointment for 10 days.