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Dermatology > 2. Pruritis > Flashcards

2. Pruritis Flashcards

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1
Q

4 Causes of Pruritis?

A
  1. Systemic Disease (CKD, Cholestasis, Malignancy)
  2. Neuropathic (MS, Zona, Notalgia paresthetica)
  3. Psychogenic
  4. Skin disease (خشکی یا التهاب پوست)
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2
Q

Mediators for Pruritis?

A
  1. Histamine (Wheal)
  2. IL-31 (Atopic Dermatitis)
  3. Prostaglandin E
  4. Substance P (neurologic causes)
  5. Mu-opioid receptor agonists (Systemic Diseases & morphin)
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3
Q

Hx:

خارش شبانه همراه با تب و تعریق

A

Hodgkin Lymphoma

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4
Q

Hx:

خارش بعد از استحمام

A
  1. Polycytemia Vera

2. Idiopathic Aquagenic Pruritis

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5
Q

Hx:

خارش شدید تر در دست و پا

A

Cholestasis ( caused by anything including Cancer in Pancreatic Head)

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6
Q

Hx:

خارش داخل بینی لوکالیزه

A

توموز مغزی

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7
Q

What will rise your suspicion for malignancy in a patient with CC of Pruritis?

A

خارش پایدار بدون علت مشخص

خارش ژنرالیزه که به درمان معمول پاسخ نمی دهد

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8
Q

What are the malignancies you should think of in a patient with pruritis?

A
  1. P vera
  2. Hodgkin lymphoma
  3. CLL
  4. Brain tumor
  5. Pancreatic Tumor
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9
Q

چه ضایعات پوستی می تواند به وسیله خاراندن ایجاد شود؟

A
  1. Excoriation (خراش)
  2. Papule
  3. Excoriated Noduls (Prurigo nodularis)
  4. Lichenification
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10
Q

Treatment for pruritis caused by malignancy?

A
  1. Paroxetine (SSRI)
  2. Mirtazapine (برای خارش شبانه و خارش های مقاوم )
  3. Thalidomide
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11
Q

Neuropathic causes for Pruritis?

A
  1. زونا
  2. MS
  3. Notalgia paresthetica
  4. Brachioradialis paresthetica
  5. Meralgia paresthetica
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12
Q

What is the treatment for Neurogenic Pruritis?

A
  1. Capsaicin (topical) ( 5 times daily for the first week, 3 times a day for the next 3-6 weeks)
  2. Gabapentin
  3. Corticosteroid Topical
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13
Q

What is Notalgia Paresthetica?

A

خارش شدید و دوره ای در قسمت داخلی اسکاپولا
در اثر خارش مکرر و طولانی ممکن است پیگمنتاسیون قهوه ای ایجاد شود

(کس نخارد پشت من، جز ناخن انگشن من)

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14
Q

What is Brachioradialis Paresthetica?

A

خارش دوره ای قسمت خارجی ارنج و ساعد
با تماس زیاد با افتاب مرتبط است

معاینه نورولوژیک و گاهی تصویر برداری مهره گردنی برای بررسی تحت فشار بودن ریشه عصبی توصیه می شود

درمان : همون قبلیا + پرهیز از افتاب

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15
Q

What is Meralgia Paresthetica?

A

خارش و سوزن سوزن شدن قسمت خارجی ران

در افراد چاق، حامله و افرادی که شلوار تنگ می پوشند دیده می شود.

(مرلین مونرو عجب رونی داره)

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16
Q

What are systemic Causes for pruritis?

A
  1. CKD
  2. Cholestasis
  3. Iron deficiency
  4. Hyperthyrodisim
  5. Hypothyridism
  6. Diabetes
17
Q

What are the characteristics of Iron deficiency Pruritis?

A

Localized or generalized
esp.
1. Anus
2. Vulva

18
Q

What are the characteristics of Hyperthyroidism Pruritis?

A

Generalized !
More common than Hypothyroidsm
Could be the first symptom of hyperthyrodisim

19
Q

What are the characteristics of Hypothyroidism pruritis?

A

Localized or generalized!
Less Common than Hyperthyroidism
چون خشکی پوست در هیپوتیرویدی شایع استو خارش می تواند ناشی از خشکی پوست باشد

20
Q

What are the characteristics of Diabetes Pruritis?

A

Caused by:

  1. Candidiasis –> location: Perianal and genital
  2. Neuropathic –> treatable by Capsaicin
21
Q

Treatment for Pruritis caused by cholestasis?

A
  1. Cholestyramine
  2. Naltrexone, Nalmefene
  3. Ursodeoxycholic acid
22
Q

Treatment for Pruritis caused by CKD?

A
  1. Treatment of Hyperparathyroidism
  2. درمان خشکی پوست
  3. Gabapentin
  4. Naltrexone
  5. Thalidomide
  6. UVB phototherapy
  7. Renal Transplantation (موثرترین درمان)
23
Q

What are the LAB Data needed for Generalized pruritis with no apparent reason?

A
  1. CBC(diff) [iron def anemia, cll, p.vera]
  2. BUN,Cr
  3. AST, ALT, ALKP, Bili
  4. Thyroid Function Test
  5. LDH
  6. ESR
    بررسی تکمیلی:
    A. FBS, HbA1c
    B. Serum Iron, ferritin
    C. Stool for ova, parasits and ocult blood
    D. Serum Protein electrophoresis
    E. CxR
24
Q

Non-medical Recommendation for treatment of pruritis?

A
  1. پوشیدن لباس نخی
  2. پرهیز از دوش گرفتن زیاد و استفاده از صابون و شامپو ملایم
  3. استفاده از مرطوب کننده مثل اوره ۵ تا ۱۰ درصد
  4. کوتاه کردن ناخن برای پرهیز از خاراندن
  5. خنک کردن یا فشار ملایم بر روی محل به جای خاراندن
  6. پرهیز از قرار گرفتن در محیط گرم
25
Q

برای برطرف کردن خشکی پوست چه درمانی انجام می شود؟

A

در بزرگسالان از اوره ۵ تا ۱۰ درصد و در کودکان اوره ۳ درصد

26
Q

Treatment for Exema prurtitis?

A 
Doxepin
Systemic Antihistamine (موضعی به درد نمی خوره)
27
Q

کی برای درمان از فتوتراپی استفاده میکنیم؟

A
  1. CKD
  2. HIV
  3. Aquagenic pruritis
  4. Hodgkin lymphoma
  5. Prurigo nodularis
28
Q

Hx:

What is your diagnosis in a person with a family history of pruritis?

A

گال

Dermatology (9 decks)

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