We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |


Earl D. Osborne, M.D.; Howard L. Stoll, M.D.
JAMA. 1959;169(2):124-127. doi:10.1001/jama.1959.03000190026007.
Text Size: A A A
Published online


Local primary irritation is by far the most frequent cause of pruritus ani et vulvae. Other causes are contact dermatitis, specific dermatological diseases, disease of the anal, rectal, and genitourinary tracts, disease of other organs, and psychogenic disturbances. Etiological diagnosis is often difficult because pruritus from any cause can exist for only a short time before visible secondary changes are induced by scratching and medication. Anal pruritus scarcely exists in geographical areas where bathing with water and no soap or toilet paper is the custom after defecation. When an organ system other than the anogenital apparatus is involved, all local sources of irritation should be removed and conservative treatment applied until the true source of the itching sensation becomes apparent. Presumed psychogenic disturbances are made worse by treatment if the diagnosis happens to be incorrect, and the supposed emotional exhaustion rapidly disappears when the real etiology is discovered and eliminated. More time should be spent on searching out the underlying cause of anogenital pruritus. Specific sensitization to condiments should not be overlooked in unsolved cases.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.