INFO - On pruritus (itching)

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American Family Physician

SCOTT MOSES, M.D., Fairview Lakes Regional Health Care, Lino Lakes,

Minnesota

15 Sep 2003

Pruritus

Pruritus is a common manifestation of dermatologic diseases, including

xerotic eczema, atopic dermatitis, and allergic contact dermatitis.

Effective treatment of pruritus can prevent scratch-induced complications

such as lichen simplex chronicus and impetigo. Patients, particularly

elderly adults, with severe pruritus that does not respond to conservative

therapy should be evaluated for an underlying systemic disease. Causes of

systemic pruritus include uremia, cholestasis, polycythemia vera, Hodgkin's

lymphoma, hyperthyroidism, and human immunodeficiency virus (HIV) infection.

Skin scraping, biopsy, or culture may be indicated if skin lesions are

present. Diagnostic testing is directed by the clinical evaluation and may

include a complete blood count and measurement of thyroid-stimulating

hormone, serum bilirubin, alkaline phosphatase, serum creatinine, and blood

urea nitrogen levels. Chest radiography and testing for HIV infection may be

indicated in some patients. Management of nonspecific pruritus is directed

mostly at preventing xerosis. Management of disease-specific pruritus has

been established for certain systemic conditions, including uremia and

cholestasis. (Am Fam Physician 2003;68:1135-42,1145-6. CopyrightC 2003

American Academy of Family Physicians.)

Pruritus is a common dermatologic problem that increases in incidence with

age. In some patients, the condition may be so severe that it affects sleep

and quality of life. While pruritus most commonly occurs in skin disorders,

it may be an important dermatologic clue to the presence of an underlying

systemic disease.

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Read the entire article here:

http://www.aafp.org/afp/20030915/1135.html

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