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Other antimalarials like amodiaquine, halofantrine, and hydroxychloroquine have also been linked to pruritus, albeit less frequently and to a lesser extent. [2] Another class of medications known to occasionally cause itching is known as serotonin reuptake inhibitors. [3] Itching is one of the most frequent adverse effects of opioid therapy. [4]
Pruritus can be seen with hepatic and renal disease such as cholestasis, alcoholic liver disease, primary biliary cholangitis, hepatitis B and C, and chronic kidney disease. [ 5 ] [ 6 ] [ 7 ] Drug and alcohol use can contribute to pruritus as well so it is worthwhile to gather a social history.
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.
If the sensation of itching persists for six weeks or longer, then it is called chronic itch or chronic pruritus. [4] [5] Chronic idiopathic pruritus or Chronic Pruritus of Unknown Origin is a form of itch that persists for longer than six weeks, and for which no clear cause can be identified. [6] [7]
Pruritus ani is the irritation of the skin at the exit of the rectum, known as the anus, causing the desire to scratch. [1] The intensity of anal itching increases from moisture, [2] pressure, and rubbing caused by clothing and sitting. At worst, anal itching causes intolerable discomfort that often is accompanied by burning and soreness.
Although the exact cause of PN is unknown, PN is associated with other dermatologic conditions such as untreated or severe atopic dermatitis and systemic causes of pruritus including liver disease and end stage kidney disease. [2] The goal of treatment in PN is to decrease itching. PN is also known as Hyde prurigo nodularis, or Picker's nodules ...
Xerosis is a contributing factor to pruritus and is present in 50–85% of patients with uremic pruritus. [16] Many studies have shown that emollients such as glycerol and paraffin, [17] physiological lipids, [18] 10% urea and dexpanthenol, [19] and baby oil [20] can reduce xerosis and pruritus in patients with uremic pruritus.
Presentation varies from person to person. Some people have discrete attacks, which can last between 10 and 120 minutes [3] while others are symptomatic almost constantly due to atmospheric humidity levels and/or sweating. Itching most frequently occurs on the legs, arms, chest, back, and abdomen, though it can also occur elsewhere. [4]