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Cholestatic pruritus is the sensation of itch due to nearly any liver disease, but the most commonly associated entities are primary biliary cholangitis, primary sclerosing cholangitis, obstructive choledocholithiasis, carcinoma of the bile duct, cholestasis (also see drug-induced pruritus), and chronic hepatitis C viral infection and other forms of viral hepatitis.
The varied causes of hyperbilirubinemia are best understood from bilirubin metabolism. The total average daily production of bilirubin in humans is 4 mg/kg. 80% of which is derived from haemoglobin (Hb) produced by erythrocyte breakdown, with the remaining from heme proteins , like myoglobin and cytochrome , turnover. [ 5 ]
Treatment options for pruritus that does not improve with anion-exchange resins include: rifampicin, naltrexone, or sertraline. [33] Rifampicin may rarely cause drug induced liver injury and should be avoided if serum bilirubin is elevated (greater than 2.5 mg/dL). Liver enzymes should be monitored after starting rifampin. [34]
Cellulitis. Cellulitis looks like a rash, but is actually an infection of the middle layer of skin, says Dr. Yadav. It causes the skin to become diffusely red, swollen, tender, and hot to the ...
Rosacea. What it looks like: Rosacea causes redness and thick skin on the face, usually clustered in the center.Easy flushing, a stinging sensation, and small, pus-filled pimples are other common ...
Jaundice, also known as icterus, is a yellowish or greenish pigmentation of the skin and sclera due to high bilirubin levels. [3] [6] Jaundice in adults is typically a sign indicating the presence of underlying diseases involving abnormal heme metabolism, liver dysfunction, or biliary-tract obstruction. [7]
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