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Pruritus in Pregnancy

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1. Effect of plasmapheresis on cholestatic pruritus and autotaxin activity during pregnancy. (PubMed)

Effect of plasmapheresis on cholestatic pruritus and autotaxin activity during pregnancy. 30614557 2019 02 14 1527-3350 2019 Jan 07 Hepatology (Baltimore, Md.) Hepatology Effect of Plasmapheresis on Cholestatic Pruritus and Autotaxin Activity During Pregnancy. 10.1002/hep.30496 Heerkens Marieke M Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands. Dedden Suzanne S Department of Gynaecology, Maastricht

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2019 Hepatology

2. Pruritus

: experts in the field from Europe. More than 30% are European Academy of Dermatology and Venereology (EADV) members 3 Abbreviations and explanations AD Atopic dermatitis AEP Atopic eruption of pregnancy CGRP Calcitonin gene-related peptide CKD Chronic kidney disease CNS Central nervous system CNPG Chronic nodular prurigo CP Chronic pruritus (longer than 6 weeks) CPG Chronic prurigo CSU Chronic spontaneous urticaria DIF Direct immunofluorescence ICP Intrahepatic cholestasis of pregnancy IFSI (...) International Forum on the Study of Itch IIF Indirect immunofluorescence IL Interleukin Itch Synonym of pruritus NRS Numerical rating scale NSAID Non-steroidal anti-inflammatory drugs PAR Proteinase-activated receptor PBC Primary biliary cirrhosis PEP Polymorphic eruption of pregnancy PG Pemphigoid gestationis Pruritus A skin sensation that elicits the urge to scratch PUO Pruritus of undetermined origin PTH Parathyroid hormone PV Polycythaemia vera RCT Randomised controlled trials SSRI Selective serotonin

2019 European Dermatology Forum

3. Prevalence and Relevance of Pruritus in Pregnancy (PubMed)

Prevalence and Relevance of Pruritus in Pregnancy Pregnant women are at greater risk to suffer from chronic pruritus, but data on this symptom in this group is very limited. The aim of this study was to investigate the prevalence, clinical characteristics, and the importance of pruritus in pregnant women. A total of 292 consecutive pregnant women at the 33.0 ± 6.1 weeks of gestation (WoG) were recruited into this prospective, cross-sectional study. All patients underwent thorough anamnesis (...) and detailed physical examination with the special emphasis on pruritus. Pruritus was assessed according to Visual Analogue Scale (VAS). Quality of life was measured with the Dermatology Life Quality Index (DLQI). The point prevalence of pruritus was 20.2% (n = 59), while pruritus prevalence during the entire pregnancy was 38.0% (n = 111). Pruritus started on average at the 27.2 ± 7.6 WoG; it was significantly more common among women in third trimester. The mean VAS was 4.8 (±2.4) points. The DLQI scoring

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2017 BioMed research international

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

variables are that iron overload is asso- ciated with both liver in?ltration 35 (see section 7.7) and Table 2 Causes of generalized pruritus without rash Pruritic skin diseases before rash Disorders of iron metabolism Uraemia Hepatic disease (especially cholestasis) Malignancy Haematological disorders Infection Endocrine disease Neurological disorders Psychological and emotional factors Adverse drug reactions Heart failure Pregnancy Pruritus of elderly skin Pruritus of unknown origin (GPUO) © 2017 (...) Pruritus is a common symptom in patients with various hepa- tobiliary disorders, including cholestasis of pregnancy. 138–140 The skin in hepatic pruritus is often generally hyperpigmented and excoriated. 141 The hands and feet are often the worst- affected areas. 139 Pruritus in association with fatigue at presen- tation may be a marker for more aggressive disease, for exam- ple primary biliary cholangitis. 142 There is a poor correlation between pruritus and bile acid levels, suggesting that other

2018 British Association of Dermatologists

5. Pruritus in Pregnancy

Pruritus in Pregnancy Pruritus in Pregnancy 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 in Pregnancy Pruritus (...) in Pregnancy Aka: Pruritus in Pregnancy , Pregnancy Related Pruritus , Pruritus gravidarum , Prurigo gravidarum II. Causes See Common, intense involving May spread to thighs, buttocks, s and arms Prurigo of Pregnancy (Common) Onset in second-half of pregnancy s and s over arms and Associated with or (uncommon) Autoimmune disorder with association Occurs in second-half of pregnancy s and bullae form on , extremities (Common) No in mild form (Prurigo gravidarum) Trunk and extremity itching without rash

2018 FP Notebook

6. Total serum bile acids or serum bile acid profile, or both, for the diagnosis of intrahepatic cholestasis of pregnancy. (PubMed)

bile acid profile, composed of primary or secondary, conjugated or non-conjugated bile acids, may provide more specific disease information.To assess and compare, independently or in combination, the diagnostic accuracy of total serum bile acids or serum bile acids profile, or both, for the diagnosis of intrahepatic cholestasis of pregnancy in pregnant women, presenting with pruritus. To define the optimal cut-off values for components of serum bile acid profile; to investigate possible sources (...) Total serum bile acids or serum bile acid profile, or both, for the diagnosis of intrahepatic cholestasis of pregnancy. Intrahepatic cholestasis of pregnancy is a pregnancy-specific liver disorder, possibly associated with an increased risk of severe fetal adverse events. Total serum bile acids (TSBA) concentration, alone or in combination with serum aminotransferases, have been the most often used biomarkers for the diagnosis of intrahepatic cholestasis of pregnancy in clinical practice. Serum

2019 Cochrane

7. Pruritus vulvae

. This can lead to vaginal dryness, itching, burning, and irritation. Pregnancy Increased hormone levels in pregnancy are associated with increased physiological vaginal discharge, and an increased risk of candidal vulvovaginitis, both of which cause vulvular pruritus. This information is based on expert opinion in narrative reviews Overview of vulvar pruritus through the life cycle [ ] and Vulvar dermatoses: a practical approach to evaluation and management [ ]. Gastrointestinal and urinary incontinence (...) changes which cause pruritus vulvae? Manage pruritus vulvae appropriately, depending on the underlying cause: Atrophic vaginitis — see the CKS topic on . Pregnancy — see the CKS topic on . Basis for recommendation Basis for recommendation The evidence to support the management of hormonal changes is discussed within the relevant CKS topic. Gastrointestinal disease and urinary incontinence How should I manage gastrointestinal disease or urinary incontinence which is causing pruritus vulvae? Manage

2017 NICE Clinical Knowledge Summaries

8. Overview of pregnancy complications

cholestasis of pregnancy (ICP) is a pruritic condition caused by impaired bile flow allowing bile salts to be deposited in the skin and the placenta. Usually presents in the third trimester with pruritus, which is worse at night, starts on the soles of feet and hands, and spares the face. Some women may present with jaundice and significant liver dysfunction, coagulopathy from vitamin K deficiency (rarely), abnormal fetal heart rate, premature labour, or intrauterine fetal demise. Risk factors include (...) Overview of pregnancy complications Overview of pregnancy complications - Summary of relevant conditions | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Overview of pregnancy complications Last reviewed: February 2019 Last updated: September 2018 Introduction Complications in pregnancy can result from conditions that are specifically linked to the pregnant state as well as conditions that commonly arise or occur incidentally in women who are pregnant

2018 BMJ Best Practice

9. Overview of pregnancy complications

cholestasis of pregnancy (ICP) is a pruritic condition caused by impaired bile flow allowing bile salts to be deposited in the skin and the placenta. Usually presents in the third trimester with pruritus, which is worse at night, starts on the soles of feet and hands, and spares the face. Some women may present with jaundice and significant liver dysfunction, coagulopathy from vitamin K deficiency (rarely), abnormal fetal heart rate, premature labour, or intrauterine fetal demise. Risk factors include (...) Overview of pregnancy complications Overview of pregnancy complications - Summary of relevant conditions | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Overview of pregnancy complications Last reviewed: February 2019 Last updated: September 2018 Introduction Complications in pregnancy can result from conditions that are specifically linked to the pregnant state as well as conditions that commonly arise or occur incidentally in women who are pregnant

2018 BMJ Best Practice

10. Safety, Tolerability and Efficacy of SNA-120 for Treatment of Pruritus and Psoriasis in Subjects Treated With Calcipotriene

Safety, Tolerability and Efficacy of SNA-120 for Treatment of Pruritus and Psoriasis in Subjects Treated With Calcipotriene Safety, Tolerability and Efficacy of SNA-120 for Treatment of Pruritus and Psoriasis in Subjects Treated With Calcipotriene - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached (...) the maximum number of saved studies (100). Please remove one or more studies before adding more. Safety, Tolerability and Efficacy of SNA-120 for Treatment of Pruritus and Psoriasis in Subjects Treated With Calcipotriene The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03448081 Recruitment Status

2018 Clinical Trials

11. Elevated serum alkaline phosphatase · generalized pruritus · Dx? (PubMed)

Elevated serum alkaline phosphatase · generalized pruritus · Dx? A 34-year-old woman was referred to the hepatology clinic for evaluation of an increased serum alkaline phosphatase (ALP) level. She was gravida 5 and in her 38th week of gestation. Her obstetric history was significant for 2 uncomplicated spontaneous term vaginal deliveries resulting in live births and 2 spontaneous abortions. The patient reported generalized pruritus for 2 months prior to the visit. She had no comorbidities (...) and denied any other symptoms. She reported no family history of liver disease or complications during pregnancy in relatives. The patient did not smoke or drink, and had come to our hospital for her prenatal care visits. The physical exam revealed normal vital signs, no jaundice, a gravid uterus, and acanthosis nigricans on the neck and axilla with scattered excoriations on the arms, legs, and abdomen. Her serum ALP level was 1093 U/L (normal: 50-136 U/L). Immediately before this pregnancy, her serum

2018 Journal of Family Practice

12. RDD1609 as a Treatment for Idiopathic Pruritus Ani

RDD1609 as a Treatment for Idiopathic Pruritus Ani RDD1609 as a Treatment for Idiopathic Pruritus Ani - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. RDD1609 as a Treatment for Idiopathic Pruritus Ani (...) by (Responsible Party): RDD Pharma Ltd Study Details Study Description Go to Brief Summary: This is a double-blind, randomized, placebo-controlled, crossover trial, to test the hypothesis that RDD1609 is effective in treating idiopathic pruritus ani. Condition or disease Intervention/treatment Phase Idiopathic Pruritus Ani Drug: RDD1609 Drug: Mebendazole 100 MG Phase 2 Detailed Description: This is a phase 2a randomized double-blinded placebo-controlled cross-over design study in patients with idiopathic

2018 Clinical Trials

13. Effect of Granisetron on Morphine Induced Pruritus in Cesarean Section

to granisetron, morphine or amide local anesthetics. Parturients with pruritogenic systemic disease. A coexisting skin disorder or preexisting pregnancy induced pruritus. Parturients with any contraindication for intrathecal anesthesia, e.g. coagulopathy. Emergency cesarean section. Psychiatric disorders. Fetal abnormalities. Failed or unsatisfactory intrathecal block. Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact (...) Effect of Granisetron on Morphine Induced Pruritus in Cesarean Section Effect of Granisetron on Morphine Induced Pruritus in Cesarean Section - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Effect

2018 Clinical Trials

14. In-Use Test With a Cosmetic Product to Treat Pruritus

In-Use Test With a Cosmetic Product to Treat Pruritus In-Use Test With a Cosmetic Product to Treat Pruritus - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. In-Use Test With a Cosmetic Product to Treat (...) Pruritus The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03477058 Recruitment Status : Completed First Posted : March 26, 2018 Last Update Posted : August 13, 2018 Sponsor: Dr. August Wolff GmbH & Co. KG Arzneimittel Collaborator: SIT Skin Investigation and Technology Hamburg GmbH Information provided

2018 Clinical Trials

15. Safety and Efficacy of PG102P for Uremic Pruritus in HD Patients

with current treatment Active infection with current treatment Current itching with dermatologic diseases other than uremic pruritus Pregnancy, childbearing potential during the study period, or breastfeeding Allergy or hypersensitivity reaction to PG102P History of participating another clinical trial within 2 months or planning to participate another clinical trial Not eligible to participate this trial as researchers' decision Contacts and Locations Go to Information from the National Library (...) Safety and Efficacy of PG102P for Uremic Pruritus in HD Patients Safety and Efficacy of PG102P for Uremic Pruritus in HD Patients - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Safety and Efficacy

2018 Clinical Trials

16. Apremilast Treatment for Pruritus and Quality of Life in Scalp Psoriasis

Apremilast Treatment for Pruritus and Quality of Life in Scalp Psoriasis Apremilast Treatment for Pruritus and Quality of Life in Scalp Psoriasis - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Apremilast (...) Treatment for Pruritus and Quality of Life in Scalp Psoriasis (APRESCALP) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03553433 Recruitment Status : Not yet recruiting First Posted : June 12, 2018 Last Update Posted : June

2018 Clinical Trials

17. Pruritus (PDQ®): Health Professional Version

Pruritus (PDQ®): Health Professional Version Pruritus (PDQ®) - PDQ Cancer Information Summaries - NCBI Bookshelf Warning: The NCBI web site requires JavaScript to function. Search database Search term Search NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health. PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. PDQ Cancer Information Summaries [Internet]. Bethesda (MD): ; 2002-. Search term Pruritus (PDQ® (...) ) Health Professional Version PDQ Supportive and Palliative Care Editorial Board . Published online: May 5, 2016. This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the pathophysiology and treatment of pruritus. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions. This summary is reviewed

2016 PDQ - NCI's Comprehensive Cancer Database

18. Cholestasis of pregnancy

disease with bile acid levels >40 micromol/L or severe pruritus remote from term can be treated effectively with ursodeoxycholic acid. Close fetal surveillance with delivery near term can be expected with premature delivery reserved for those with severe, worsening disease despite treatment. Definition Intrahepatic cholestasis of pregnancy (ICP) is a pruritic condition during pregnancy caused by impaired bile flow allowing bile salts to be deposited in the skin and the placenta. The cause (...) -quality evidence found higher incidence of respiratory distress syndrome in neonates delivered of mothers who suffered from intrahepatic cholestasis of pregnancy. Poor quality observational (cohort) studies or methodologically flawed randomized controlled trials (RCTs) of <200 participants. History and exam presence of risk factors pruritus, sparing the face excoriations without rash mild jaundice previous hx of intrahepatic cholestasis of pregnancy (ICP) hx hepatitis C FHx of intrahepatic cholestasis

2017 BMJ Best Practice

19. Prognostic and mechanistic potential of progesterone sulfates in intrahepatic cholestasis of pregnancy and pruritus gravidarum. (PubMed)

Prognostic and mechanistic potential of progesterone sulfates in intrahepatic cholestasis of pregnancy and pruritus gravidarum. A challenge in obstetrics is to distinguish pathological symptoms from those associated with normal changes of pregnancy, typified by the need to differentiate whether gestational pruritus of the skin is an early symptom of intrahepatic cholestasis of pregnancy (ICP) or due to benign pruritus gravidarum. ICP is characterized by raised serum bile acids and complicated (...) pregnancy = 29/100), demonstrating that all three progesterone sulfates are prognostic for ICP. Concentrations of progesterone sulfates were associated with itch severity and, in combination with autotaxin, distinguished pregnant women with itch that would subsequently develop ICP from pruritus gravidarum (group 2: ICP n = 41, pruritus gravidarum n = 14). In a third group of first-trimester samples all progesterone sulfates were significantly elevated in serum from low-risk asymptomatic women who

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2015 Hepatology

20. Pruritus ani

- 281 . BUMPS ( 2014 ) Chlorphenamine. Best Use of Medicine in Pregnancy. UK Teratology Information Services . [ ] Chaudhry,V. and Bastawrous,A. ( 2003 ) Idiopathic pruritus ani. Seminars in Colon & Rectal Surgery. 14 ( 4 ), 196 - 202 . DTB ( 2002 ) Oral antihistamines for allergic disorders. Drug & Therapeutics Bulletin. 40 ( 8 ), 59 - 62 . [ ] Fargo, M.V and Latimer, K.M ( 2012 ) Evaluation and management of common anorectal conditions. . Foxx-Orenstein, A.E., Umar, S.B. and and Cromwell, M.D (...) Pruritus ani Pruritus ani - NICE CKS Share Pruritus ani: Summary Pruritus ani is a skin condition characterized by the sensation of perianal itching or burning. It is a symptom, not a diagnosis, and it can be categorized as primary (idiopathic) or secondary (has a specific underlying cause). Primary pruritus ani is thought to be functional or psychological in nature: Functional pruritus ani — a small amount of faecal loss (anorectal dysfunction) causes itching and perianal erythema

2016 NICE Clinical Knowledge Summaries

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