Skin Ailments—Pruritus
Pruritus (itching)
General—clinical finding that can result from a dermatologic disease or a systemic condition.
Mechanism—can be due to release of histamine or serotonin, neuropathy, immune based, medications, and so on.
Diagnostic algorithm
Get history and physical examination.
If typical skin findings, then treat accordingly; if atypical, consider biopsy and/or scraping; if no skin findings, then initiate empiric therapy with skin hygiene and oral antihistamines.
If treatment is not effective (and/or diagnosis is unclear), then evaluate further.
Classification
Dermatologic causes
Urticaria (hives)—transient condition mediated by histamine
Dermatitis (see Chapter 2.51.)
Psoriasis—silvery scaly patches
Ectoparasites (see Chapter 2.52.)
Systemic causes (10%-50% of those with generalized pruritus have a systemic etiology.)
Medication (e.g., opioids)
Thyroid disease (either hypothyroidism or hyperthyroidism)
Uremia
Liver disease
Malignancy (e.g., Hodgkin’s disease, multiple myeloma.)Related posts:
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