PRURITIS

• It is defined as that unpleasant sensation which produces the desire to scratch. Pruritis may be generalized or localized, acute or chronic. Certain areas of the skin particularly susceptible to pruritis are ear canals, perianal and genital areas, eyelids etc.

• Trigger: Chemical, mechanical or thermal stimuli as well as exposure to certain mediators ( serotonin, histamine etc)
• Localized pruritis is usually caused by a dermatological condition whereas generalized pruritis can also have systemic, neurologic, psychogenic or mixed causes

Localized pruritis:

• Primary skin lesion is present. If primary skin lesion is absent it can be neuropathic or psychogenic pruritis
• In the scalp, pruritis may be due to psoriasis or ongoing folliculitis
• In the inguinal or anal region- due to prutitis ani, pruritis vulvae, pruritis scroti, veneral diseases, scabies, pediculosis
• In the hands and feet due to psoriasis, contact dermatitis
• In the mid back due to nostalgia paresthetia, macular amyloidosis
• In the lower limbs in older patients due to asteatosis

Systemic disorders :

• Endocrine – DM, hyperthyroidism, hypoparathyroidism, myxoedema
• Hepatic – cholestasis, Hepatitis B and C virus infection, cholestasis of pregnancy
• Renal – chronic renal insufficiency
• Blood disease (hematological) – iron deficiency anaemia, leukemia, multiple myeloma, mycosis fungoides, mast cell disorders
• Intestinal parasites – infestation with hookworm, round worm, pin worm
• Collagen vascular disorders – SLE
• Neurological – Multiple sclerosis, brain tumour
• Pregnancy

Psychogenic pruritis – psychosomatic disorders resulting in itch commonly occur in middle aged or older individuals

Iatrogenic pruritis – induced by opium alkaloids, CNS stimulants, antidepressants, belladonna alkaloids

• History & clinical examination
• ESR, Liver function , Renal function tests
• Blood sugar, urea nitrogen , creatinine
• Hepatitis screening
• Patch test

• Treatment should be done depending on the cause

Internal medicines

• Amruthavrisha patoladi kashaya
• Amrutha rajanyadi kashaya
• Avipathi Choorna
• Guda + Ardraka swarasa - reduces itching