Pruritus Flashcards
Pruritus meaning
a sensation provoking a desire to scratch, with or without skin lesions
Pruritus: • lesions may arise from the __________, or from excoriation causing -_____, _____, or ________
-underlying disease
- causing crusts, lichenified plaques, or
wheals
Pruritus. 3 groups of etiologies
- dermatologic – generalized
- dermatologic – local
- systemic disease – usually generalized
• dermatologic – generalized Pruritus.
Causes of Pruritus
■ asteatotic dermatitis (“winter itch” due to dry skin)
■ pruritus of senescent skin (may not have dry skin, any time of year)
■ infestations: scabies, lice
■ drug eruptions: ASA, antidepressants, opiates
■ psychogenic states
dermatologic – local Pruritus.
Causes of Pruritus
■ atopic and contact dermatitis, lichen planus, urticaria, insect bites, dermatitis herpetiformis
■ infection: varicella, candidiasis
■ lichen simplex chronicus
■ prurigo nodularis
hepatic. renal
Causes of Pruritus
■ hepatic: obstructive biliary disease, cholestatic liver disease of pregnancy
■ renal: chronic renal failure, uremia secondary to hemodialysis
–hematologic
Causes of Pruritus
■ hematologic: Hodgkin’s lymphoma, multiple myeloma, leukemia, polycythemia vera,
hemochromatosis, Fe deficiency anemia, cutaneous T-cell lymphoma
■ neoplastic:
Causes of Pruritus
lung, breast, gastric (internal solid tumours), non-Hodgkin’s lymphoma
■ endocrine:
Causes of Pruritus
carcinoid, DM, hypothyroid/thyrotoxicosis
Causes of Pruritus ■ infectious:
HIV, trichinosis, echinococcosis, hepatitis C
Causes of Pruritus ■ psychiatric:
depression, psychosis
■ neurologic: Causes of Pruritus
post-herpetic neuralgia, multiple sclerosis
Pruritus Investigations
blood work: CBC, ESR, Cr/BUN, LFT, TSH, fasting blood sugar, stool culture, and serology for parasites
Pruritus Management, main idea
treat underlying cause
Pruritus Management. Local measures (no drugs)
cool water compresses to relieve pruritus
• bath oil and emollient ointment (especially if xerosis is present)
