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Pruritus Causes

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1. Interventions for pruritus of unknown cause [Cochrane protocol]

Interventions for pruritus of unknown cause [Cochrane protocol] Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g

2019 PROSPERO

2. British Association of Dermatologists? guidelines for the investigation and management of generalized pruritus in adults without an underlying dermatosis

. Symptomatic measures may be appro- priate in patients where no cause can be identi?ed or treated. More directed management can be divided into topical treat- ments, systemic treatments, phototherapy, psychological approaches or alternative therapies. 5,24 Palliative care is a spe- cialized situation and, in general, the therapy of the pruritus should be centred on the individual circumstances of the patient. 25 7.0 Investigation of generalized pruritus without rash and interventions for secondary (...) Aprospectivecase–controlstudyshowedthatthemeanserum ironlevelsinthepopulation ofpatients withpruritus wassignif- icantly lowerthanthat inthecontrolgroup,with nomedianage differencebetweenthetwogroups.Furthermore,themostcom- mon cause of generalized pruritus in patients with underlying systemicdiseasewasfoundtobeironde?ciencyanaemia,which respondedtoironreplacement(25%ofallpatientswithpruritus with systemic disease). 30 Therefore, we recommend that full blood count and ferritin levels should be checked in all

2018 British Association of Dermatologists

3. Expression of IL-22 in the Skin Causes Th2-Biased Immunity, Epidermal Barrier Dysfunction and Pruritus via Stimulating Epithelial Th2 Cytokines and the GRP Pathway (PubMed)

Expression of IL-22 in the Skin Causes Th2-Biased Immunity, Epidermal Barrier Dysfunction and Pruritus via Stimulating Epithelial Th2 Cytokines and the GRP Pathway Increased expression of Th22 cytokine IL-22 is a characteristic finding in atopic dermatitis (AD). However, the specific role of IL-22 in the pathogenesis of AD in vivo has yet to be elucidated. Consistent with observations in human AD, IL-22 was significantly increased in the AD skin of mice after epicutaneous sensitization to house (...) dust mite allergen. Utilizing a skin-specific inducible transgenic system, we show in the present study that expression of IL-22 in the skin of mice caused an AD-like phenotype characterized by chronic pruritic dermatitis associated with Th2-biased local and systemic immune responses, downregulation of epidermal differentiation complex genes, and enhanced dermatitis upon epicutaneous allergen exposure. IL-22 potently induced the expression of gastrin-releasing peptide (GRP), a neuropeptide

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2017 Journal of immunology (Baltimore, Md. : 1950)

4. Pharmacological interventions for pruritus in adult palliative care patients. (PubMed)

Pharmacological interventions for pruritus in adult palliative care patients. This is an update of the original Cochrane review published in 2013 (Issue 6). Pruritus occurs in patients with disparate underlying diseases and is caused by different pathologic mechanisms. In palliative care patients, pruritus is not the most prevalent but is one of the most puzzling symptoms. It can cause considerable discomfort and affects patients' quality of life.To assess the effects of different (...) pharmacological treatments for preventing or treating pruritus in adult palliative care patients.For this update, we searched CENTRAL (the Cochrane Library), and MEDLINE (OVID) up to 9 June 2016 and Embase (OVID) up to 7 June 2016. In addition, we searched trial registries and checked the reference lists of all relevant studies, key textbooks, reviews and websites, and we contacted investigators and specialists in pruritus and palliative care regarding unpublished data.We included randomised controlled trials

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2016 Cochrane

5. Pruritus Causes

Pruritus Causes Pruritus Causes Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Pruritus Causes Pruritus Causes Aka: Pruritus Causes (...) , Dermatologic Causes of Pruritus , Systemic Causes of Pruritus , Localized Causes of Pruritus , Medication Causes of Pruritus , Environmental Causes of Pruritus II. Causes: Dermatologic Conditions or (most common cause) ( suggests worse prognosis) Local Infection or bites corporis (lice) s III. Causes: Systemic Severe ( ) or (30-50%) Provoked by hot shower or bath Pricking type itch may persist for hours Rapid weight loss (e.g. ) (4-11% long-standing ) Cholestasis (bile salt protease release in skin) See

2018 FP Notebook

6. Systemic Mastocytosis Causing Refractory Pruritus in a Liver Disease Patient (PubMed)

Systemic Mastocytosis Causing Refractory Pruritus in a Liver Disease Patient Systemic mastocytosis (SM) results from clonal, neoplastic proliferation of abnormal mast cells. Patients become susceptible to itching, urticaria, and anaphylactic shock, which occurs due to histamine release from mast cells. SM may coexist alongside other systemic diseases, thus confounding the overall clinical presentation. We discuss a 23-year-old woman with refractory pruritus, which was initially attributed (...) to primary sclerosing cholangitis but had a nonresponse to antihistaminics, ursodiol, and cholestyramine. Concurrent evaluation for polyarthritis revealed increased uptake in the proximal femur on a bone scan, and subsequent bone marrow biopsy revealed indolent SM, and this was understood to be the cause of her intractable pruritus.

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2016 ACG case reports journal

7. Can genetic testing guide the therapy of cholestatic pruritus? A case of benign recurrent intrahepatic cholestasis type 2 with severe nasobiliary drainage‐refractory itch (PubMed)

Can genetic testing guide the therapy of cholestatic pruritus? A case of benign recurrent intrahepatic cholestasis type 2 with severe nasobiliary drainage‐refractory itch Benign recurrent intrahepatic cholestasis (BRIC) is a peculiar familial disease caused by mutations of the genes encoding hepatocanalicular flippase for phosphatidylserine (ATP8B1; BRIC type 1) or the bile salt export pump (ABCB11; BRIC type 2). Here, we report on a patient with nasobiliary drainage-refractory BRIC type 2

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2018 Hepatology communications

8. Multilevel symmetric neuropathic pruritus (MSNP) presenting as recalcitrant "generalized" pruritus. (PubMed)

of atherosclerosis. Twelve of 14 (85.7%) patients noted complete or near complete resolution after treatment with gabapentin (300-1200 mg daily).No healthy age-matched control group without pruritus was investigated.A combination of multilevel degenerative disc disease of the spine, spinal nerve root impingement, and/or nerve root traction may play a pivotal role in the cause of multilevel symmetric neuropathic pruritus.Copyright © 2016 American Academy of Dermatology, Inc. All rights reserved. (...) Multilevel symmetric neuropathic pruritus (MSNP) presenting as recalcitrant "generalized" pruritus. Chronic itch is a disruptive and disabling condition that can lead to psychological stress and depression.We sought to describe an entity of generalized, symmetric, neuropathic pruritus, which we term "multilevel symmetric neuropathic pruritus," and offer possible explanations accounting for its pathogenesis.A case series of 14 patients was evaluated at academic institutions from 2011 to 2015.All

2016 Journal of American Academy of Dermatology

9. Pruritus in Patients Under Targeted Anticancer Therapy: A Multidimensional Analysis Using the 5-D itch Scale. (PubMed)

receiving EGFRIs suffer from severe pruritus frequently. They not only experienced long lasting and intense itching, causing sleep discomfort, but also developed itching at specific body sites. (...) Pruritus in Patients Under Targeted Anticancer Therapy: A Multidimensional Analysis Using the 5-D itch Scale. Pruritus is a very common symptom in patients, undergoing targeted anticancer therapy. However, the characteristics of pruritus, according to the targeted anticancer agents, are still unclear. The objective of this study was to determine the characteristics of pruritus, induced by targeted anticancer agents, using a questionnaire-based survey. The survey was administered to cancer

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2019 Acta Dermato-Venereologica

10. European S2k Guideline on Chronic Pruritus. (PubMed)

European S2k Guideline on Chronic Pruritus. Pruritus is a frequent symptom in medicine. Population-based studies show that every 5th person in the general population has suffered from chronic pruritus at least once in the lifetime with a 12-month incidence of 7%. In patient populations its frequency is much higher depending on the underlying cause, ranging from around 25% in haemodialysis patients to 100% in skin diseases such as urticaria and atopic dermatitis (AD). Pruritus may be the result (...) of a dermatological or non-dermatological disease. Especially in non-diseased skin it may be caused by systemic, neurological or psychiatric diseases, as well as being a side effect of medications. In a number of cases chronic pruritus may be of multifactorial origin. Pruritus needs a precise diagnostic work-up. Management of chronic pruritus comprises treatment of the underlying disease and topical treatment modalities, including symptomatic antipruritic treatment, ultraviolet phototherapy and systemic treatment

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2019 Acta Dermato-Venereologica

11. Examining the association between pruritus and quality of life in patients with atopic dermatitis treated with crisaborole. (PubMed)

Examining the association between pruritus and quality of life in patients with atopic dermatitis treated with crisaborole. Pruritus is a leading cause of reduced health-related quality of life (QoL) in atopic dermatitis (AD). Crisaborole ointment is a non-steroidal phosphodiesterase 4 inhibitor for the treatment of mild-to-moderate AD. In identical Phase 3 studies (NCT02118766, NCT02118792), crisaborole reduced disease and pruritus severity versus vehicle.Quantify the relationship between (...) pruritus and QoL using data from these studies.Patients aged ≥2 years were randomly assigned 2 : 1 to receive crisaborole:vehicle twice daily for 28 days. QoL was measured at baseline and day 29 using the Dermatology Life Quality Index (DLQI; patients aged ≥16 years), the Children's Dermatology Life Quality Index (CDLQI; patients aged 2-15 years) and the Dermatitis Family Impact (DFI; caregivers of patients aged 2-17 years). Pruritus was measured using the Severity of Pruritus Scale (SPS), a 4-point

2019 Journal of the European Academy of Dermatology and Venereology

12. Comparison of pruritus and sensory qualities induced by capsaicin, histamine and cowhage. (PubMed)

Comparison of pruritus and sensory qualities induced by capsaicin, histamine and cowhage. In skin diseases and experimental models of pruritus, pure itch is accompanied by additional sensations that are poorly characterized.This study compared the sensory qualities evoked by different models of experimentally induced pruritus including skin prick testing (SPT) with histamine or capsaicin and application of cowhage spicules. SPT as a method of capsaicin application was validated (...) , and the overall evaluation of sensory descriptors were recorded on a 100-mm visual analogue scale once itching had subsided.Skin prick testing with histamine and capsaicin resulted in flare reactions, which were 23% smaller for capsaicin (P < 0.001). Histamine, capsaicin and cowhage-induced pruritus, the duration of which was shorter for cowhage than for histamine (13.5 ± 1.4 vs. 8.8 ± 1.2 min, P = 0.005). Different mediators induced sensations of different intensities. Capsaicin produced less itch

2019 Journal of the European Academy of Dermatology and Venereology

13. Defining the role of mirtazapine in the treatment of refractory pruritus. (PubMed)

Defining the role of mirtazapine in the treatment of refractory pruritus. Background/Objective: Mirtazapine has traditionally been used for the treatment of major depressive disorder, with an added benefit in patients who have comorbid insomnia or anxiety. Recent studies describe its usefulness in treating refractory pruritus of various causes as well. Our goal is to better define the use of mirtazapine in the treatment of refractory pruritus. Method: Through a thorough literature review (...) of PubMed, we identified all reports of the use of mirtazapine for pruritus. Results: Upon examination of 8 supporting articles, we found mirtazapine has quality evidence for the treatment of intra-thecal morphine-induced pruritus. Mirtazapine may also be effective in treating pruritus related to various other conditions, including psoriasis, atopic dermatitis, cutaneous malignancies (primary or metastatic), hematologic malignancies (lymphomas and leukemias), liver failure, renal failure, cholestasis

2019 Journal of Dermatological Treatment

14. Reasons for underreporting of uraemic pruritus in people with chronic kidney disease: A qualitative study. (PubMed)

Reasons for underreporting of uraemic pruritus in people with chronic kidney disease: A qualitative study. Uraemic pruritus, or itch, is common in people with chronic kidney disease (CKD) and has a negative impact on their lives and well-being. However, for reasons currently unknown, itch often remains unreported and therefore untreated.To explore reasons for underreporting of itch in order to provide pointers for improving itch reporting and management in people with CKD.We interviewed adult (...) patients with CKD who self-reported experiencing itching in the last three years (n=25), nephrologists (n=10) and nurses (n=12) from three kidney services in the United Kingdom. Topic guides were informed by previous studies and a theoretical model of self-regulation. We conducted a thematic analysis of verbatim transcripts using Framework Analysis.We identified three main themes reflecting factors that may influence whether itch is reported: knowledge on causes and treatment of itch (lack of awareness

2019 Journal of pain and symptom management

15. Pruritus in ordinary scabies: IL-31 from macrophages induced by overexpression of thymic stromal lymphopoietin and periostin. (PubMed)

Pruritus in ordinary scabies: IL-31 from macrophages induced by overexpression of thymic stromal lymphopoietin and periostin. Scabies is a common contagious skin disease caused by an infestation of the skin by Sarcoptes scabiei var. hominis. A hallmark symptom of scabies is severe itch.We sought to determine the generation of a pruritogenic cytokine, interleukin (IL)-31, together with immune profiles in skin lesions of ordinary scabies through immunohistochemical and immunofluorescent studies

2019 Allergy

16. Which patients with chronic pruritus are presented for psychological assessment by their dermatologists? Results from a consecutive sample. (PubMed)

Which patients with chronic pruritus are presented for psychological assessment by their dermatologists? Results from a consecutive sample. Chronic pruritus (CP) is a frequent symptom that poses special diagnostic and therapeutic challenges for dermatologists. To identify the causes underlying CP, a comprehensive multidisciplinary assessment is necessary1,2 . CP can impair life quality and can be associated with clinically relevant depression and anxiety levels; also, a psychiatric comorbidity (...) can be present independent of CP, but it may affect its dermatological management1,3,4 . However, not all CP patients undergo a psychological assessment. It remains unclear which individual variables of CP patients would suggest a referral for a psychological assessment by their dermatologists. We sought to investigate this relationship in a large sample of CP patients attending the Center for Chronic Pruritus (KCP) at the University of Münster. Between 2007 and 2016, data from 6,374 consecutive

2019 British Journal of Dermatology

17. Infectious differential diagnosis of chronic generalized pruritus without primary cutaneous lesions: a review of the literature. (PubMed)

dermatological findings are observed, the physician easily comes to a diagnosis and treats the condition, whereas, when primary lesions are not detected, the diagnosis can become challenging, and some patients have to undergo extensive evaluations. The association between some systemic disorders and chronic generalized pruritus is widely known and confirmed. Many infections have been associated with pruritus, but few are considered to cause chronic generalized pruritus without any characteristic skin lesions (...) . We aimed to gather all the available data on infectious causes of chronic generalized pruritus with no diagnostic cutaneous lesions to assist fellow physicians in the process of evaluation of these challenging cases.© 2019 The International Society of Dermatology.

2019 International Journal of Dermatology

18. Pharmacological interventions for pruritus in adult palliative care patients. (PubMed)

Pharmacological interventions for pruritus in adult palliative care patients. Pruritus is not the most prevalent but one of the most puzzling symptoms in palliative care patients. It can cause considerable discomfort and has a major impact on patients' quality of life. In the field of palliative care, pruritus is a symptom occurring in patients with disparate underlying diseases and based on different pathologic mechanisms but ending in the same phenomenon. The pathogenesis of pruritus (...) to determine. Therefore, identifying the underlying cause of pruritus is of prime importance in order to develop tailored treatment plans, even if in palliative care the treatment is focused towards the symptom and not necessarily the underlying disease.Results show that in palliative care patients with pruritus of different natures, treatment with the drug paroxetine, a selective serotonin reuptake inhibitor, may be beneficial. For patients suffering from pruritus associated with HIV infection

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2013 Cochrane

19. Long-term efficacy and safety of nalfurafine hydrochloride on pruritus in chronic liver disease patients: Patient-reported outcome based analyses. (PubMed)

Long-term efficacy and safety of nalfurafine hydrochloride on pruritus in chronic liver disease patients: Patient-reported outcome based analyses. Among various symptoms accompanied with chronic liver disease, pruritus affects the quality of life of patients, causing physical and mental stress, and worsens hepatic function. Recently, κ-opioid receptor agonist, nalfurafine hydrochloride was approved to treat central pruritus in patients with liver disease in Japan. This study aimed to assess (...) the long-term efficacy and safety of nalfurafine hydrochloride on pruritus in chronic liver disease patients.A patient-reported outcome using questionnaire-based methods was used for 41 liver disease patients with or without pruritus symptoms. Nalfurafine hydrochloride (2.5 μg/day) was orally administered to 18 patients suffering from pruritus symptoms and whose current treatment was not effective. The same questionnaires and visual analogue scales (VAS) were repeatedly followed up for the patients

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2017 PLoS ONE

20. Acupuncture for reducing pruritus induced by intrathecal morphine at elective cesarean delivery: a placebo-controlled, randomized, double-blind trial. (PubMed)

Acupuncture for reducing pruritus induced by intrathecal morphine at elective cesarean delivery: a placebo-controlled, randomized, double-blind trial. Intrathecal morphine is a standard postoperative analgesic administered after cesarean delivery, but frequently causes pruritus. Acupuncture reportedly resolves refractory pruritus in certain patients. The aim of the study was to investigate the effectiveness of acupuncture in preventing pruritus induced by intrathecal morphine.Thirty parturients (...) postoperatively. The primary outcome was the incidence of postoperative pruritus. Adverse effects including nausea and vomiting were also investigated.There were no significant differences between the acupuncture group and the control group in the incidence of pruritus (67% vs. 67%, P=1.000, RR 1.0 [95% CI 0.60 to 1.66]) or the requirement for antipruritic therapy (6.7% vs. 20.0%, P=0.283, RR 0.33 [95% CI 0.04 to 2.85]). The incidence of postoperative nausea in the acupuncture group versus control group

2018 International journal of obstetric anesthesia

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