Psoriasis is one of the most widespread dermatoses in the world with incidence about 2%. There are various clinical forms of psoriasis. One of the clinical varieties is inverse psoriasis, which is characterized by lesions of intertriginous areas, in particular the perianal area. Psoriasis in perianal area does not always have the clinical characteristics of typical plaque psoriasis. The scientific evidence accumulated to date suggests that patients with inverse psoriasis report a lower quality of life compared to patients with other psoriasis localizations. Localization of psoriasis in an area prone to maceration makes it difficult to carry out a differential diagnosis, which can lead to errors in the diagnosis, irrational treatment and increase the patient’s anxiety. The objective of this review is to systematize the available information on the clinical diagnosis and treatment of psoriasis in perianal area. The authors discuss in detail the features of the clinical manifestations of psoriasis in perianal area and the issues of differential diagnosis. Dermoscopy can be helpful in the diagnosis of psoriasis, especially in cases of unusual anatomical locations and/or manifestations. Therapies widely used in the treatment of plaque psoriasis in other areas of the skin may not always be suitable for the treatment of lesions in the intertriginous area, where the skin is significantly thinner, has more glands and is constantly exposed to pollution and friction. The best strategy in the treatment of psoriasis in perianal area may be to alternate topical calcineurin inhibitors or vitamin D analogs with short courses of topical glucocorticosteroids.

Keywords: vitamin D analogues, perianal region, genetically engineered drugs, topical calcineurin inhibitors, dermatoscopy, phosphodiesterase-4 inhibitors, glucocorticosteroids, psoriasis