Pruritus (Prt)
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Pruritus (Prt): Clinical Overview
Overview
Pruritus (Prt) is the medical term for itching—an unpleasant skin sensation provoking the desire to scratch. It is a common symptom encountered in dermatology and general medical practice, with causes ranging from benign and self-limited to signals of underlying systemic disease.
Causes and Mechanisms
- Dermatologic causes: Dry skin (xerosis), eczema (atopic dermatitis), contact dermatitis, psoriasis, urticaria, infections, scabies, and lichen planus are frequent culprits for localized or generalized itch.
- Systemic disease: Chronic kidney disease, cholestatic liver disease, thyroid disorders, diabetes, iron deficiency anemia, polycythemia vera, lymphoma, and other malignancies can present with widespread pruritus, often without a primary rash.
- Neuropathic and psychogenic causes: Itch may arise from nerve damage (neuropathy, multiple sclerosis, post-herpetic neuralgia), psychogenic/psychiatric conditions (anxiety, depression, OCD), or side effects of medications.
- Medications and pregnancy: Certain drugs (opioids, antibiotics, antihypertensives) and hormonal changes during pregnancy, especially cholestatic pruritus, can also trigger or worsen itching.
Clinical Presentation
- Pruritus may be acute or chronic, localized or generalized, and may or may not be associated with a visible skin rash.
- Chronic itch can lead to excoriations, secondary infection, sleep disturbance, and reduced quality of life.
- Evaluation includes a detailed history, skin exam, and assessment for systemic symptoms or changes in general health.
Evaluation and Management
- Assessment: Identify obvious dermatologic triggers, take an exposure and medication history, and screen for systemic etiologies if pruritus is generalized or chronic without skin findings.
- Management: Treat underlying skin or systemic disease, recommend emollients for dryness, topical steroids for inflammation, antihistamines for symptomatic relief, and tailored systemic treatments for refractory cases. Psychogenic or neuropathic itch may require specialist management.
- It is important to maintain skin hydration, avoid irritant exposures, and use gentle skincare routines.
Summary
Pruritus is a multifactorial symptom often associated with skin disease, systemic illness, nerve disorders, medications, or psychological states. Thorough assessment and targeted management are key for effective relief and to identify serious underlying conditions.
Consult with Our Team of Experts Now!
For persistent or unexplained pruritus, consult dermatologists or specialists in internal medicine for comprehensive evaluation and therapy planning.
References
- Mayo Clinic. Itchy skin (pruritus): Symptoms and causes. 2024.mayoclinic
- AAFP. Pruritus: Diagnosis and Management. 2022.aafp
- PMC. Pruritus: An Updated Look at an Old Problem. 2003.pmc.ncbi.nlm.nih
- Medscape. Pruritus and Systemic Disease. 2025.emedicine.medscape
- WebMD. Pruritus (Chronic Itchy Skin): Causes and Treatments. 2024.webmd
