Chronic pruritus
G Yosipovitch, JD Bernhard - New England Journal of Medicine, 2013 - Mass Medical Soc
G Yosipovitch, JD Bernhard
New England Journal of Medicine, 2013•Mass Medical SocKey Clinical Points Chronic Pruritus Chronic pruritus (itching that persists for more than 6
weeks) may be caused by inflammatory skin diseases, systemic diseases, neuropathic
conditions, and psychogenic disorders. The presence of a rash does not necessarily
indicate a primary skin disease; lichenification, prurigo nodules, patches of dermatitis, and
excoriations result from rubbing and scratching. The initial evaluation of a patient who has
pruritus of undetermined origin should include a complete blood count with a differential …
weeks) may be caused by inflammatory skin diseases, systemic diseases, neuropathic
conditions, and psychogenic disorders. The presence of a rash does not necessarily
indicate a primary skin disease; lichenification, prurigo nodules, patches of dermatitis, and
excoriations result from rubbing and scratching. The initial evaluation of a patient who has
pruritus of undetermined origin should include a complete blood count with a differential …
Key Clinical Points
Chronic Pruritus
- Chronic pruritus (itching that persists for more than 6 weeks) may be caused by inflammatory skin diseases, systemic diseases, neuropathic conditions, and psychogenic disorders.
- The presence of a rash does not necessarily indicate a primary skin disease; lichenification, prurigo nodules, patches of dermatitis, and excoriations result from rubbing and scratching.
- The initial evaluation of a patient who has pruritus of undetermined origin should include a complete blood count with a differential count, a chest radiograph, and tests of hepatic, renal, and thyroid function. Patients with itch of undetermined origin should be reevaluated periodically.
- In the initial treatment of symptoms, the use of mild cleansers, emollients, topical anesthetics, and coolants may be helpful.
- Sedating antihistamines may be used, primarily to help the patient sleep.
- Anticonvulsants, antidepressants, and mu-opioid antagonists appear to be helpful in some forms of chronic itch.
The New England Journal Of Medicine