Chronic Pruritus: Pruritus is an itchy, irritated, or uncomfortable sensation on the skin that can progress and become persistent through time. It can be a result of a wide variety of causes, some that result from natural wear and tear, and others that are allergy-related. In some cases, a natural thinning of the skin in older patients leads to dryness in skin and itching. In other cases, irritation or allergic reactions from environmental or pollen allergens, contact allergens such as clothes, medications, or cosmetics, can result in eczema, hives, rashes, or other skin conditions that cause chronic pruritus. Nerve disorders in diabetic patients or people with multiple sclerosis can also cause a constant itching sensation, and the same goes for certain systemic conditions such as lymphoma, liver disease, or kidney failure. Psychiatric disorders such as anxiety or obsessive-compulsive disorder can cause chronic pruritus. We have also come to find that sensory receptors are also involved as part of the itching cycle.
- Symptoms: redness, bumps, cracked skin, dry skin, itching.
- Diagnosis: skin prick testing to environmental allergens or patch testing to chemicals is the most effective way to determine an allergy-associated cause of the itchiness. To identify other causes, blood tests will be necessary to determine systemic conditions, and a detailed history to evaluate for any psychiatric conditions that may contribute.
Treatments:
Treating the underlying cause by removing allergens, identifying, and properly treating systemic conditions, nerve disorders, or psychiatric disorders would be the main long-term goal for resolving chronic pruritus. However, corticosteroid ointments and oral antihistamines can help decrease symptoms. Biologics are currently under development for chronic pruritus in addition to medications that are geared towards targeting the sensory receptors.
