Figure 113.1
The perineum is a diamond‐shaped region that lies below the pevic floor. A transverse imaginary line drawn between the ischial tuberosities divides th...
Figure 113.5
A 4‐month‐old female child with a perianal infantile haemangioma.
Figure 113.9
Perianal and natal cleft psoriasis causing fissures in a 42‐year‐old woman.
Figure 113.13
Hailey–Hailey disease affecting the ano genital region and causing inflammation and superficial blistering. A skin biopsy has been taken for histology...
Figure 113.17
Furunculosis affecting the buttocks of a 22‐year‐old female.
Figure 113.21
Florid perianal warts in a 5‐year‐old male.
Figure 113.25
Squamous cell carcinoma infiltrating adipose tissue that has developed from adjacent high‐grade anal intraepithelial neoplasia. Magnification 400×. (...
Figure 113.29
(a) Infiltrative carcinoma erysipeloides affecting the genito‐crural region and lower abdomen in a man with adenocarcinoma of the colon. A colostomy b...
Figure 113.33
(a) Pilonidal sinuses in a natal cleft with buttock abscesses. (b) Close‐ up view of the same pilonidal sinus.
Figure 113.37
Cryptoglandular hypothesis of the development of an intersphincteric fistula.
Figure 113.41
Second degree prolapsed internal haemorrhoids with surrounding anal tags. (Courtesy of Mr M. Abulafi, Croydon University Hospital, UK.)
Figure 113.2
Coronal section through the anal canal. (From Standring 2008 [ ].)
Figure 113.6
Excoriations secondary to idiopathic pruritus ani in a 6‐year‐old boy. It is important to exclude threadworms at this age.
Figure 113.10
Contact dermatitis causing blistering in an infant due to the use of wet wipes.
Figure 113.14
Perianal contact dermatitis caused by imiquimod cream used to treat perianal warts.
Figure 113.18
Ulcerated and inflamed skin affecting the natal cleft and buttock secondary to herpes simplex type II virus infection.
Figure 113.22
Histopathology of low‐grade anal intraepithelial neoplasia. Koilocytes are present high in the upper half of the epidermis. Magnification 200×. (Cour...
Figure 113.26
(a) Large polypoid mass of perianal carcinoma in a 56‐year‐old female. (b) Close‐up view of the same carcinoma.
Figure 113.30
Hurley stage I hidradenitis suppurativa presenting as chronic furunculosis on the buttocks.
Figure 113.34
MRI scan of the patient with sacrococcygeal pilondal disease shown in Figure A sagittal T 2 ‐weighted small field of view image showing multiple sin...
Figure 113.38
Parks classification of anal fistulae. A: superficial fistula track beneath the internal and external sphincters. B: intersphincteric fistula track be...
Figure 113.42
Perianal skin tag.
Figure 113.3
Muscles of the pelvic floor in a female. The levator ani muscle complex is composed of the ischiococcygeus, iliococcygeus and pubococcygeus muscles. T...
Figure 113.7
Vegetative pemphigus foliaceous. (a) Affecting the genito‐crural region and lower abdomen. (b) Affecting the perianal region and buttocks in the same ...
Figure 113.11
Lichen sclerosus. (a) Ano‐genital lichen sclerosus in a female in a typical figure‐of‐eight configuration. (b) Perianal lichen sclerosus.
Figure 113.15
Perianal ulceration due to nicorandil. (Courtesy of Dr S. Baron and Dr E. Kulakov, Kent, UK.)
Figure 113.19
Condylomata lata. (Courtesy of Dr S. Gold, London.)
Figure 113.23
Histopathology of high‐grade anal intraepithelial neoplasia (AIN). (a) High‐grade, full‐thickness AIN. Magnification 100×. (b) High‐grade AIN occurrin...
Figure 113.27
Poorly differentiated, eroded, perianal nodule of squamous cell carcinoma present at the anal margin occurring in a 50‐year‐old HIV‐negative man withi...
Figure 113.31
Hurley stage II hidradenitis suppurativa. (a) Affecting the groin of a female causing sinus track formation and scarring. (b) Affecting the axilla of ...
Figure 113.35
Crohn disease: perianal and buttock involvement. (Courtesy of Dr D. I. McCallum, Inverness, UK.)
Figure 113.39
Typical positions of development of internal haemorrhoids in the anal canal at 3, 7 and 11 o'clock seen with the patient in the dorsal lithotomy posit...
Figure 113.43
Obstetric perineal trauma. (a) Cloacal‐like defect following a missed third degree tear. The perineal body is absent and there is minimal tissue separ...
Figure 113.4
Partitioning of the cloacal membrane into the uro‐genital membrane and anal membrane with the formation of the perineum occurs at 5–7 weeks’ gestation...
Figure 113.8
Seborrhoeic dermatitis affecting the natal cleft and perianal skin.
Figure 113.12
Perianal lichen planus showing Wickham's striae. (Courtesy of Dr F. Ive, Durham, UK.)
Figure 113.16
Panton–Valentine leukocidin Staphylococcus aureus infection affecting the buttock of a 3‐year‐old female.
Figure 113.20
Perianal wart. (a) Low power histological features of a perianal wart showing hyperkeratosis, acanthosis and papillomatosis. Magnification 40×. (b) Hi...
Figure 113.24
Eroded patch of perianal high‐grade intra‐epithelial neoplasia (Bowen disease) in a 75‐year‐old female.
Figure 113.28
Buschke–Löwenstein tumour affecting the perianal skin of a 56‐year‐old male.
Figure 113.32
Hurley stage III severe hidradenitis suppurativa. (a) Affecting the perineum and causing extensive keloid scar formation in a 75‐year‐old male patient...
Figure 113.36
Classification of ano‐rectal abscesses based on the relation of the abscess to the internal and external anal sphincters.
Figure 113.40
Origin of internal and external haemorrhoids. (Adapted from Snell 2012 [ ]. Reproduced with permission of Lippincott Williams & Wilkins/Wolters Kluwe...