ANAL furunculosis is a chronic, painful and progressive condition of the perianal region characterised by single or multiple ulcerated tracts. These lesions may be isolated or more extensive and can affect the entire circumference of the anus. The disease is also referred to as perianal sinus or perianal fistula, although the presence of true fistulous tracts extending from the anorectal canal to the skin is uncommon. A presumptive diagnosis of anal furunculosis may be made following clinical examination but definitive diagnosis requires histopathological examination of tissue samples from the affected area. Treatment is fraught with difficulties and conservative medical therapy fails almost without exception. A number of surgical treatments have been evaluated and, recently, there has been renewed interest in medical treatment of the condition using immunomodulatory agents. The various options are discussed in this article.
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