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Itching and burning in the anus. Taking methetrexate for arthritis. Causes?

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Orthopaedic Surgeon
Practicing since : 1994
Answered : 10278 Questions
I am 42 1.55cm and 70kg, I use 20mg methetrexate per week for arthritis. I have a burning itch around my anus and perineum, and the skin at the base of my bottom. I thought that it might be thrush, but using canestan makes the itch and burn worse. There is no discolouration or obvious rash on the effected skin. It does not appear inflamed or dry. Any kind of moisture makes the burning sensation worse.
Posted Fri, 13 Apr 2012 in Digestion and Bowels
Answered by Dr. Praveen Tayal 2 hours later
Thanks for posting your query.
The burning and itching of perineum without any visible rash could be due to local dryness, rough and raw mucosa due to methotrexate intake or a symptom of nerve compression at sacrococcygeal level.
It needs a local examination and few investigations like MRI of lumbosacral spine for diagnosis.
Meanwhile for symptomatic relief-
1. Apply 1% hydrocortisone ointment and lidocaine gel for pain and itch relief locally.
2. Take multivitamin and methylcobalamin supplements.
3. Consider reducing dose of methotrexate after consulting with your physician.
I suggest you to get an appointment from your physician to know the nature of the problem. Earlier the diagnosis, better will be the treatment.
I hope this answers your query effectively.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.
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