Pruritus Skin Condition : What Is It ? Treatment and Advice For
Patient
Pruritus is a medical term for itchy skin.
Approximate age group
All ages.
Presentation
In generalised pruritus, the patient presents with itchy skin all over with
no visible rash but may have evidence of excoriation due to scratching. A
detailed history is required as there are many possible causes of pruritus,
which include the following.
Anaemia
Check serum iron and ferritin levels.
Polycythemia rubra vera
(itching especially after a hot bath) Check full blood count (FBC).
Uraemia
(also seen in 80% of patients on maintenance haemodialysis) Check
creatinine and urea.
Obstructive jaundice
(may occur in patients with primary biliary cirrhosis before jaundice
occurs) Check liver function tests and autoimmune profile.
Thyroid disease
Both hypo- and hyperthyroidism: check T4 and thyroid stimulating hormone
levels.
Lymphoma
Especially in young adults, check for enlarged lymph nodes clinically and
on chest x-ray.
HIV/AIDS
Check HIV ELISA test.
Drying out of skin
Common in older people.
Body lice
Look for lice and nits in the seams of underwear.
Psychological
Look for evidence of depression, anxiety or emotional upset
Treatment
If the history fits with any of the above causes, carry out appropriate
tests or refer to relevant specialist. If no cause can be found, treatment
should be symptomatic. Start with 10% crotamiton cream twice a day.
Complete emollient therapy should also be prescribed. If this does not
help, a moderately potent topical steroid should be considered. If the itch
is not settling and is interfering with sleep, a sedative antihistamine
should be prescribed to be taken an hour before going to bed. Advise adults
to be careful about driving the next day.
0.5% menthol in aqueous/hydrophilic cream may also be useful to relieve the
itch.
Traffic light
The patient often feels dirty and may describe a feeling of something
crawling under the skin.
Reassure that this is a medical condition which
can be treated. Encourage frequent use of emollients and encourage patting
(not rubbing) skin dry after bathing.
Keep Your Healthy ! Pruritus Skin Condition, Treatment and Advice For Patience,Disease
Sunday, December 23, 2018
Pruritus Skin Condition : What Is It ? Treatment and Advice For Patient
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