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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Impetigo herpetiformis is a rare pustular disorder affecting mainly pregnant women. We report a 16-yr-old adolescent primigravida, who presented with impetigo herpetiformis at 27 weeks gestation. She had a pustular erythroderma covering her entire body, except face, scalp, and palmoplantar regions, with severe pruritus and pain. After unsuccessful attempts of treatment with systemic corticosteroids, intravenous fluids, and antibiotics, treatment was switched to cyclosporine, but no therapeutic effect could be achieved. Because of the deteriorating condition of the patient, an early delivery decision was made. Her symptoms resolved after delivery, and at day 20 postpartum her skin lesions were completely resolved.
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PMID:Impetigo herpetiformis unresponsive to therapy in a pregnant adolescent. 1280 35

Pruritus is a common manifestation of dermatologic diseases, including xerotic eczema, atopic dermatitis, and allergic contact dermatitis. Effective treatment of pruritus can prevent scratch-induced complications such as lichen simplex chronicus and impetigo. Patients, particularly elderly adults, with severe pruritus that does not respond to conservative therapy should be evaluated for an underlying systemic disease. Causes of systemic pruritus include uremia, cholestasis, polycythemia vera, Hodgkin's lymphoma, hyperthyroidism, and human immunodeficiency virus (HIV) infection. Skin scraping, biopsy, or culture may be indicated if skin lesions are present. Diagnostic testing is directed by the clinical evaluation and may include a complete blood count and measurement of thyroid-stimulating hormone, serum bilirubin, alkaline phosphatase, serum creatinine, and blood urea nitrogen levels. Chest radiography and testing for HIV infection may be indicated in some patients. Management of nonspecific pruritus is directed mostly at preventing xerosis. Management of disease-specific pruritus has been established for certain systemic conditions, including uremia and cholestasis.
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PMID:Pruritus. 1452 1

From the clinician's point of view, pruritus in children is quite frequent. It mainly occurs along with dermatoses but rarely with systemic diseases such as renal and liver failure or with genetic disorders. Mostly, it appears in the setting of atopic dermatitis (AD). Other frequent differential diagnoses comprise e.g. scabies, impetigo, varicella, tinea, urticaria, mastocytosis and psoriasis. In children, pruritus is most often associated with severe scratching leading to artefacts. This group of patients requires a therapeutical regimen of its own. The use of topical and systemic treatments depends on the underlying aetiology of pruritus and the stage and status of the skin. The physician has to consider that topically applied drugs may cause intoxication due to the different body volume/body surface proportion, especially in newborns and infants. The dosages of systemic drugs need to be adapted in children and UV phototherapy should be performed with caution due to possible longterm photo damage of the skin. Physicians feel more insecurity treating pruritus in children, especially when systemic treatments are taken into consideration. We want to highlight the major aetiologies of pruritus in children and point out the cornerstones of antipruritic therapy in this challenging group of patients in recognition of our own clinical experiences and the current literature.
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PMID:[Pruritus in childhood. A diagnostic and therapeutic challenge]. 1534 Jul 11

In an attempt to determine the prevalence of various skin infections in the homeless population in Marseilles, France, we undertook a case control study. Cases were recruited among institutionalized homeless subjects during two snapshot investigations conducted in January 2002 and 2003 respectively. The control subjects were recruited from among those who presented at a clinic for pre-travel advice. We recruited 498 cases and 200 control subjects. Compared to control subjects, a significantly higher proportion of cases had skin diseases (38% versus 0.5%; p < 0.0001). Pruritus, body-lice infestation, scratching lesions, folliculitis, tinea pedis, scabies and impetigo (ecthyma) were strongly significantly associated with homelessness. The higher prevalence of skin infections in the homeless people mainly results from the body-louse infestation, scabies, bacterial super-infection of skin surfaces that have been breached by frequent scratching and tinea pedis due to poor foot hygiene.
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PMID:Prevalence of skin infections in sheltered homeless. 1617 49

The skin is a highly exposed organ during vacation times, especially during travel to countries with subtropical and tropical climates. Prolonged stay in these countries significantly increases the risk of contracting rarely seen dermatoses such as leishmaniasis, larva migrans and myiasis. The bites of various flies may provoke itching and excoriations that may be infected with Staphylococcus aureus and/or hemolytic streptococci, resulting in impetigo, furunculosis or erysipelas. Elderly persons spending weeks in the tropical sun may develop drug-induced phototoxic or photoallergic rash due to concomitant medication for cardiovascular or rheumatic diseases. Acute sunburn is considered a short-lasting problem, but in children it increases the risk of malignant melanoma in later years. Also of concern is chronic UV exposure, which increases the risk of premalignant and malignant skin tumors. Finally, mucocutaneous manifestations arising weeks and months after returning from vacation should raise suspicions of sexually transmitted syphilis and HIV.
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PMID:[Dermatologic problems arising during foreign travel]. 1625 Oct 95

A wide range of clinical manifestations may be seen in scabies, from classic pruritic papules and burrows to secondary features such as impetigo. Bullus lesions are a less frequent. Twenty cases of scabies presenting with bullae have been reported so far in the medical literature. Differentiating this subtype of scabies from the immunobullous disease bullus pemphigoid is a diagnostic challenge. A 42-year-old man was referred to our dermatology outpatient clinic with 3-month history of severe pruritus and tense blisters affecting mainly the lower trunk, arms and legs. An initial biopsy was suggestive for bullous pemphigoid. Close physical examination revealed small excoriated papules and a few burrows on borders of the hands and wrists. Skin scraping of the lesions on wrists was positive for Sarcoptes scabiei. Another biopsy specimen from a recent blister revealed subepidermal bullae with fibrin and inflammatory cells, particularly eosinophils. Direct immunofluorescence exam was negative. The patient was treated with lindane lotion followed by crotamiton cream with near complete resolution of the lesions. Scabies must be considered in patients presenting with recent onset of unexplained pruritic bullous lesions. Biopsy and immunofluorescence studies together with skin scrapings for Sarcoptes scabiei could help to differentiate these cases from bullous pemphigoid. Antiscabietic treatment results in resolution of bullous lesions in the affected patients.
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PMID:Scabies presenting with bullous pemphigoid-like lesions. 1663 87

Atopic dermatitis (AD), also known as eczema, is a chronic skin condition, characterized by itch (pruritus) and dryness (xerosis). AD lesions appear as pruritic red plaques that ooze when scratched. Children with AD are excessively sensitive to irritants such as scented products and dust due to their impaired skin barrier and skin immune responses. AD is among the most common disorders of childhood and its incidence is increasing. AD is an all-encompassing disease that causes sleep disturbances in the affected child, disrupting the entire household. Patients with AD also are prone to bacterial overgrowth, impetigo, and extensive viral infections. Consequently, familiarity with the most recent literature is of utmost importance so that dermatologists and pediatricians can appropriately manage their patients.
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PMID:Atopic dermatitis in children, part 1: epidemiology, clinical features, and complications. 1712 Oct 59

Various metabolic events may lead to dermatologic pathology. Three illustrative examples are glucagonoma syndrome, uremic pruritus, and zinc deficiency. The glucagonoma syndrome, resulting from a glucagon secreting-tumor, is characterized by a distinctive dermatitis, necrolytic migratory erythema. This skin rash is a generalized, pruritic eruption which first appears as erythematous patches, then progresses to form superficial vesicles and bullae. Uremic pruritus is a clinical phenomenon seen in patients with chronic renal failure; it provokes vigorous scratching and may lead to numerous cutaneous lesions including extensive excoriations, lichen simplex chronicus, prurigo nodularis, keratotic papules, or secondary impetigo. Zinc deficiency may be evident as an inherited disease called acrodermatitis enteropathica, which presents clinically with a predominately acral and periorificial rash of sharply demarcated erythematous, exfoliative, and exudative patches. It may also result from an acquired defect with similar clinical findings. A brief review concerning the etiology, clinical manifestations, diagnosis, and treatment are given for glucagonoma syndrome, uremic pruritus, and zinc deficiency. Any pathophysiologic dysfunction that results in a loss of metabolic control of homeostasis in the body may demonstrate cutaneous manifestations. These skin findings may be of great clinical significance and may aid in the diagnosis or even be the first sign of a disease process. The glucagonoma syndrome, uremic pruritus, and zinc deficiency are three examples of dermatologic correlates of metabolic events.
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PMID:Dermatologic correlates of selected metabolic events. 1731 68

Any pruritus occurring in pregnant women may represent a sensorial manifestation unrelated to pregnancy, but it may represent the consequence of a pregnancy-specific dermatosis. This latter group encompass pruritus gravidarum with or without intrahepatic cholestasis, pemphigoid gestationis, polymorphic eruption of pregnancy, prurigo gestationis, acute folliculitis of pregnancy, impetigo herpetiformis and the progesterone auto-immune dermatitis. Fetal risk of morbidity is recognized for pruritus gravidarum with intrahepatic cholestasis, pemphigoid gestationis and impetigo herpetiformis.
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PMID:[How I explore...pruritus in a pregnant woman]. 1828 48

We present a familial infection caused by Arthroderma vanbreuseghemii. The proband is a 4-year-old boy, who had played with rabbits at his rabbit-farm neighbor. He complained of pruritus and pain in his scalp, which displayed redness, alopecia and painful cysts and eventually discharged pus and scabbed. Several erythema on his face and abdomen were also presented. He was diagnosed as having impetigo but antibacterial agents were not effective and his clinical condition did not improve. Several days later, his parents also developed facial erythema and scaling. The development of a kerion in the boy and tinea corporis in his parents were diagnosed based on the positive KOH examination. Morphologic and biochemical characteristics confirmed that their infections were caused by the zoophilic Trichophyton mentagrophytes, while sequencing of the internal transcribed spacer (ITS) 1/4 polymerase chain reaction products, amplified from primary culture isolates, established its Arthroderma vanbreuseghemii lineage. Random amplified polymorphic DNA (RAPD) analysis indicated these isolates might be the same strain and that infection cruciata occurred in this family. Semi-quantitative analysis of these strains indicated multiple and main enzymatic activities of alkaline phosphatase, beta-glucosaccharase. The boy was cured through treatment with itraconazole 100 mg/day orally in combination with topical washes with 2% ketoconazole shampoo, and his parents were successfully treated by topical application of terbinafine cream.
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PMID:Arthroderma vanbreuseghemii infection in three family members with kerion and tinea corporis. 1911 35


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