Systemic Conditions of Puritis Flashcards
Medications that can cause puritis:
ACEi
Anabolic hormones
ASA
Methylphenidate
Narcotics
Testosterone
Sulfonamides: TMP-SMX (bactrim)
Vitamin A
Pt Presents with:
jtelangiectasia, epistaxis, syanosis, purpura and koilonychias
What is the most likely diagnosis
Polycythemia very
absolute increase in circulating RBC w a hematocrit level of 55-80%
Aquagenic puritis
s/s
Itching, burning, or stinging induced by bath, shower, pool
lasts 30-60 min
pt. with the puritis have a lower mean corpuscular volume and higher leukocyte counts
Treating puritis of Polycythemia Vera
what is the most effective treatment
Hydroxyzine (as reported by PCV pts)
you can also use ASA or H1 antihistamines
pt presents with severe, burning puritis.
The patient states that the itching is so bad he can’t sleep
What is the most likely diagnosis?
Hodgkin lymphoma
On a blood smear you see Reed-Sternberg giant cells
Associated with EBV.
pt experienced red raised lesions after the skin is rubbed
What is the most likely diagnosis?
What cytokine is associated with chronic itching?
Mastocytosis- an abnormal accumulation of mast cells in the body
IL-4 can initiate chronic itching in the setting of inflammation but also independently of pathways directly linked to inflammation
what is the pathway that stimulates chronic itching?
Sensory neurons are activated by immune-signaling molecule IL-4.
IL-4 → JAK1
JAK1 is the critical component of chronic itching
What is the DOC for turning off JAK when treating Eczema?
how about chronic idiopathic puritis?
Dupilumab
**idiopathic puritis= tofacitinib which was originally approved for RA
What is the most appropriate OMT technique for Derm?
Myofacial Release
