Brief Answer:
need further investigations as well as clinical evaluation..

Detailed Answer:
Hello XXXX, Welcome Back,

Thanks for following up, yes I've gone through all the details,

First of all, please upload the prescription of the Dermatologist so that I can have a detailed look at it..also if possible, then please take a few snapshots of the affected area and upload it here..

Good to know that you don't have diabetes, however the anal itching may not be related to this, and might have a relation with the past history of anal fistula, can you please tell me what treatment did you receive for that(any surgical procedure for closure or any thing else) ?

There can also be a chance of worm infestation(which may be responsible for this recurrent anal itching), so it's better to get clinically examined by a General Surgeon / Proctologist who'll examine that area to assess further and some investigations accordingly(CBC, Stool Routine Microscopy and/ some more depending on the findings)..

Actually, the examining doctor of yours always has an upper hand in this scenario as I don't have the privilege to examine you clinically, so i need more details for further assessment, hope you'll understand why i'm asking so many questions..

Meanwhile continue this current regime of medications as already advised by the Dermatologist..

Let me know how you stay in the due course..

Awaiting for your response..

Take Care
Kind Regards

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Brief Answer:
Yes , please do so.... I'm glad to help you out also..

Detailed Answer:
Dear XXXX, Welcome back..

Yes do let me know as soon as you receive the updates..

You can simply take the photos from your XXXXXXX and upload, no need to scan then..

Be extra cautious about drinking water, (specially when you go out and roam), always drink only mineral/ U.V.R.O purified water

Do keep me updated how it goes in the due course..

Take Care
Kind Regards

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