Tag year-old, skin healthy woman presented with several weeks of painful defecation accompanied by a small amount of bleeding.
Examination revealed an anal fissure anal the anterior position.
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After several months of conservative photos with sitz baths, stool softeners, and increased fluid intake, the fissure had not healed. She experienced more pain, bleeding with every bowel movement, and the formation of a nontender skin tag in the anterior position. Topical nitroglycerin and topical diltiazem were not effective, and she continued to develop tags and circumferential fissures see accompanying figure.
Based on photos patient's history and physical examination, www wet pussy games one of the following is the most likely diagnosis?
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The answer is E: Crohn's disease is a chronic, transmural disease that can affect any part of the alimentary canal, from the mouth to the perianal tissue. Perianal disease is the initial sign of Crohn's disease in approximately 20 to 36 percent of persons and can precede active intestinal disease by months to years.
Lymphatic obstruction from Crohn's disease can cause large, nontender, thick, and bluish or skin-colored perianal skin anal. Condylomata acuminata are caused by the human papillomavirus and can appear in the perianal area tag gray-tan, cauliflower-like growths that may become very large.
Lesions will turn white with application of dilute acetic acid.