Introduction and objectives:

to analyse the clinical and epidemiological characteristics of perianal dermatitis cases caused by group A beta-haemolytic streptococcus (GABHS).

Material and methods:

prospective case series with collection of data for a period of 8 years in an outpatient paediatrics clinic.

Results:

there were 95 episodes (1/298 visits) diagnosed in 76 children (predominantly boys, 1.6/1). The mean age was 4.5 years. Thirteen patients had more than one episode, with a total of 19 recurrent episodes, 10 of them within 6 months of the previous episode (11% of the total number of episodes). The most frequent presenting complaints were itching, bleeding, pain, constipation and perianal erythema. Treatment was topical in 70% of the initial episodes, and combination therapy (topical and systemic) was used in 68% of recurrent episodes. The initial treatment failed in 3 cases. The seasonal case distribution was similar to that of pharyngotonsillitis and scarlet fever caused by GABHS in the same time period.

Conclusions:

five presenting complaints (itching, bleeding, pain, constipation and perianal erythema), alone or in combination, were present in 92% of the episodes. Perianal erythema was the presenting complaint in only 17% of the first episodes. Erythema can be faint and its borders are not always well demarcated, and may manifest with associated satellite lesions.

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