Pruritus

Pruritus, also known as itch, is an unpleasant sensation that causes a person to want to scratch the affected area. It is a common symptom that can be caused by a variety of factors, including skin conditions, systemic diseases, and external stimuli.

Causes of Pruritus

• Skin conditions: eczema (atopic dermatitis), psoriasis, contact dermatitis, lichen planus, and keratosis pilaris
• Systemic diseases: kidney disease, liver disease, thyroid disorders, diabetes, and certain types of cancer (e.g., lymphoma, leukemia)
• External stimuli: insect bites, dry skin, soaps, detergents, and other irritants
• Neurological conditions: multiple sclerosis, peripheral neuropathy, and shingles (herpes zoster)
• Nutritional deficiencies: vitamin B12 deficiency, iron deficiency, and zinc deficiency
• Pregnancy and hormonal changes: pruritus can occur during pregnancy or with hormonal fluctuations during menopause or puberty

Types of Pruritus

• Acute pruritus: sudden onset, typically lasts for a short period (less than 6 weeks)
• Chronic pruritus: persistent itch that lasts for more than 6 weeks
• Generalized pruritus: affects the entire body
• Localized pruritus: affects a specific area of the body

Symptoms and Signs

• Itching sensation, which can range from mild to severe
• Scratching, which can lead to skin damage, infection, or scarring
• Redness, swelling, or inflammation of the affected area
• Small bumps or blisters (papules or vesicles)
• Dry, cracked, or thickened skin (lichenification)

Diagnosis and Treatment

Diagnosing pruritus involves a thorough medical history, physical examination, and laboratory tests to identify the underlying cause. Treatment depends on the underlying cause and may include:

• Topical creams or ointments (e.g., corticosteroids, antihistamines, or moisturizers)
• Oral medications (e.g., antihistamines, corticosteroids, or immunosuppressants)
• Lifestyle changes (e.g., avoiding irritants, using gentle soaps, and maintaining good skin hygiene)

Complications

If left untreated or poorly managed, pruritus can lead to complications such as:

• Skin infections (e.g., cellulitis, impetigo)
• Scarring or skin damage from scratching
• Sleep disturbances and fatigue
• Anxiety, depression, or other mental health issues