Pruritus is a topic covered in the Select 5-Minute Pediatrics Topics.

To view the entire topic, please or purchase a subscription.

5-Minute Clinical Consult Explore these free sample topics:

5-Minute Clinical Consult

-- The first section of this topic is shown below --

Basics

Description

Pruritus, or itch, is one of the most frequent dermatologic complaints. It is an unpleasant sensation characterized by the reflexive behavior to scratch and is a symptom associated with numerous inflammatory and infectious skin diseases. However, generalized and persistent pruritus without or with minimal skin changes may be a presenting feature of a variety of systemic diseases.

Pathophysiology

  • Itch-specific peripheral nerves are unmyelinated afferent C-fibers.
  • Pruritus depends on the complex interplay of neuroinflammatory modulators among peripheral nerves, keratinocytes, and leukocytes as well as CNS processing.
  • There are numerous mediators of pruritus, although histamine is the prototypical pharmacologic target for many patients.

Etiology

  • Dermatologic: arising from skin disease
  • Systemic: arising from noncutaneous organ systems including metabolic causes, drugs, and multifactorial disorders
  • Neurogenic: arising from disorders of the central or peripheral nervous system
  • Psychogenic: arising from primary psychiatric disorders
  • Mixed: coexistence of more than one etiology of pruritus
  • Idiopathic: pruritus of uncertain etiology

-- To view the remaining sections of this topic, please or purchase a subscription --