Itch natural history, complications and prognosis: Difference between revisions

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==Natural History, Complications and Prognosis==
==Overview==
The scientific term for itching is pruritis. The word pruritis is derived from the Latin word Prurire which means to itch. <ref name="pmid27849111">{{cite journal| author=Siemens W, Xander C, Meerpohl JJ, Buroh S, Antes G, Schwarzer G | display-authors=etal| title=Pharmacological interventions for pruritus in adult palliative care patients. | journal=Cochrane Database Syst Rev | year= 2016 | volume= 11 | issue=  | pages= CD008320 | pmid=27849111 | doi=10.1002/14651858.CD008320.pub3 | pmc=6734122 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27849111  }} </ref>
The history, progression, and complications of pruritus are diverse and based on the cause.


In 1660, the German physician Samuel Hafenreffer defined pruritis as "an unpleasant sensation associated with the desire to scratch". <ref name="pmid27849111">{{cite journal| author=Siemens W, Xander C, Meerpohl JJ, Buroh S, Antes G, Schwarzer G | display-authors=etal| title=Pharmacological interventions for pruritus in adult palliative care patients. | journal=Cochrane Database Syst Rev | year= 2016 | volume= 11 | issue=  | pages= CD008320 | pmid=27849111 | doi=10.1002/14651858.CD008320.pub3 | pmc=6734122 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27849111  }} </ref>
==Natural History==
In patients with malignancies, [[pruritus]] could be the first sign. In [[allergic reactions]], [[pruritus]] may be one of the hallmark features. [[Pruritus]] after hot baths is a finding associated with [[hematologic malignancies]].


In modern medicine, pruritus is used in reference to a pathological condition in which the sensations of itch are intense and often generalized and stimulate repeated scratching in an attempt to alleviate the discomfort. Pruritus is not a disease, but rather a common and still poorly understood symptom of both localised and systemic disorders that may accompany many conditions. <ref name="pmid16296999">{{cite journal| author=Bernhard JD| title=Itch and pruritus: what are they, and how should itches be classified? | journal=Dermatol Ther | year= 2005 | volume= 18 | issue= 4 | pages= 288-91 | pmid=16296999 | doi=10.1111/j.1529-8019.2005.00040.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16296999 }} </ref>
==Complications==
Secondary [[bacterial infections]] can occur when [[bacteria]] are introduced through breaks in the skin brought about by scratching. [[Lichenification]], the thickening of skin as a result of chronic scratching, can also be seen <ref name="pmid22207450">{{cite journal| author=Lee KC, Keyes A, Hensley JR, Gordon JR, Kwasny MJ, West DP | display-authors=etal| title=Effectiveness of acupressure on pruritus and lichenification associated with atopic dermatitis: a pilot trial. | journal=Acupunct Med | year= 2012 | volume= 30 | issue= 1 | pages= 8-11 | pmid=22207450 | doi=10.1136/acupmed-2011-010088 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22207450 }} </ref>.


Pruritis is important in many medical specialities, and notably to palliative care. Although pruritus is not the most commonly seen symptom seen in advanced terminal disease, it is among the most puzzling symptoms. It can cause considerable discomfort in patients receiving cancer therapy or in other types of terminal diseases. The itch‐scratch‐itch cycle adversely affects skin integrity, resistance to infections, and quality of life as much as pain can affect a patient. It can also lead to feelings of embarrassment which can impact a social patient's life. <ref name="pmid27849111">{{cite journal| author=Siemens W, Xander C, Meerpohl JJ, Buroh S, Antes G, Schwarzer G | display-authors=etal| title=Pharmacological interventions for pruritus in adult palliative care patients. | journal=Cochrane Database Syst Rev | year= 2016 | volume= 11 | issue=  | pages= CD008320 | pmid=27849111 | doi=10.1002/14651858.CD008320.pub3 | pmc=6734122 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27849111  }} </ref>
==Prognosis==
Pruritus by itself never has a poor prognosis besides its effects on comfort and mental health. However, the underlying causes of pruritus have diverse prognoses, with malignancies being the poorest. Skin irritations such as with poison ivy often produce no lasting effects once treated.





Latest revision as of 01:34, 14 August 2021


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogechukwu Hannah Nnabude, MD

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Overview

The history, progression, and complications of pruritus are diverse and based on the cause.

Natural History

In patients with malignancies, pruritus could be the first sign. In allergic reactions, pruritus may be one of the hallmark features. Pruritus after hot baths is a finding associated with hematologic malignancies.

Complications

Secondary bacterial infections can occur when bacteria are introduced through breaks in the skin brought about by scratching. Lichenification, the thickening of skin as a result of chronic scratching, can also be seen [1].

Prognosis

Pruritus by itself never has a poor prognosis besides its effects on comfort and mental health. However, the underlying causes of pruritus have diverse prognoses, with malignancies being the poorest. Skin irritations such as with poison ivy often produce no lasting effects once treated.


References

  1. Lee KC, Keyes A, Hensley JR, Gordon JR, Kwasny MJ, West DP; et al. (2012). "Effectiveness of acupressure on pruritus and lichenification associated with atopic dermatitis: a pilot trial". Acupunct Med. 30 (1): 8–11. doi:10.1136/acupmed-2011-010088. PMID 22207450.

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