PRURITUS

DEFINITION

 Pruritus is defined as an unpleasant sensation that provokes the

desire to scratch
Pathophysiology
Clinical Assessment
Time course
Localisation
Exacerbating factors
Involvement of other family members
General health of the patient
Sudden: infestations, urticarial
Chronic: eczema
Localised: lichen planus, lichen simplex
Generalised: eczema, scabies
Genital region: diabetes mellitus
Increased by heat, reduced by
cooling
Scabies infestations, insect bites
Systemic diseases
Classification

 Pruritus associated with skin diseases

 Pruritus in pregnancy
 Pruritus associated with systemic diseases
Medical conditions
Management

 Depends on the cause, require several trials of treatment

 Treat reversible cutaneous or systemic cause
 Xerosis
 Minimising soap and water exposure
 Emollients
 Atopic dermatitis:
 Keep nails short and manicured
 Emollients (menthol, aqueous cream)
 Lichen simplex
 Capsaicin
 Urticaria
 Non-sedative H1-antagonist (fexofenadine,mloratadine)
 Atopic dermatitis, itch secondary to renal disease
 Phototherapy
 Itch of hepatic disorders
 Opiate antagonists
 Cholestatic pruritus
 Rifampicin
Reference

 Davidson’s Principle and Practice of Medicine 21st ed

 BMJ Best Practice
 medscape