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

This study evaluates the ability of hydroxyzine and various neuroleptics to suppress histamine-induced pruritus in ten volunteer subjects with the use of a double-blind crossover protocol. The itch threshold was determined in each volunteer by intradermal injection of gradually increasing concentrations of histamine. Volunteers were then given the study drugs and placebo at the same interval of time, under near identical conditions, and the itch threshold was determined. Thiothixene, hydroxyzine hydrochloride, chlorpromazine, thioridazine, and a lactose placebo were evaluated. Compared to other drugs, hydroxyzine alone was more effective in the suppression of histamine-induced itch. Consequently, hydrozyzine may be more effective in histamine-induced pruritus. The neuroleptic drugs used in this study do not significantly suppress histamine-induced pruritus, but they may be beneficial in nonhistamine-induced pruritus or psychogenic pruritus.
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PMID:Suppression of histamine-induced pruritus by hydroxyzine and various neuroleptics. 4 38

Psychogenic pruritus and self-excoriation are diagnoses of exclusion. Elimination of traditional organic causes often leads the clinician to label a symptom as psychogenic in origin and limits treatment options. This article examines the organic and psychologic causes and concomitants of dermatologic conditions associated with pruritus and self-excoriation. An organized cognitive framework is presented to guide the clinician in the evaluation and treatment of these patients. Specific treatment options are offered and relevant psychopharmacologic agents are reviewed.
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PMID:Evaluation and treatment of "psychogenic" pruritus and self-excoriation. 771 May 55

A patient's psychological condition can substantially affect the presence and severity of pruritus, a phenomenon thought to be mediated by the central nervous system's (CNS) opioid neurotransmitter system. Specific psychodermatologic disorders associated with psychogenic pruritus, including depression, anxiety, chronic tactile hallucinations, delusions of parasitosis, neurotic excoriations, and other cutaneous compulsions are likely controlled by this pathway. Therefore, in treating these conditions, medications specifically directed at the CNS can be the most effective therapies, whereas topical and supportive therapy may be important adjuncts in targeting the associated pruritus. Furthermore, the impact of an understanding clinician and a good physician-patient relationship cannot be underestimated in determining ultimate prognosis. This review will begin by discussing the relationship between the psyche and pruritus as well as the opioid neurotransmitter system. Following this, several disorders characterized by psychogenic pruritus will be described, and CNS-specific and adjunctive topical and supportive therapies for these conditions will be detailed.
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PMID:Psyche, opioids, and itch: therapeutic consequences. 1629 3

Functional itch disorder or psychogenic pruritus is a poorly defined diagnosis. This paper sets out the proposed diagnostic criteria of the French Psychodermatology Group (FPDG). There are three compulsory criteria: localized or generalized pruritus sine materia, chronic pruritus (>6 weeks) and the absence of a somatic cause. Three additional criteria from the following seven items should also be present: a chronological relationship of pruritus with one or several life events that could have psychological repercussions; variations in intensity associated with stress; nocturnal variations; predominance during rest or inaction; associated psychological disorders; pruritus that could be improved by psychotropic drugs; and pruritus that could be improved by psychotherapies.
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PMID:Functional itch disorder or psychogenic pruritus: suggested diagnosis criteria from the French psychodermatology group. 1759 38

Pruritus can be divided into several categories: pruritoceptive, neurogenic, neuropathic, and psychogenic. Neuropathic itch is caused by lesions of afferent neural pathways. Psychogenic itch is secondary to primary psychiatric disorders. Both of these types of pruritus present with no evidence of primary cutaneous lesions. The presentation of both conditions can be confusing and patients with no primary cutaneous lesions can be prematurely diagnosed as having a psychiatric disorder. Treatment of neuropathic and psychogenic pruritus can be divided into pharmacologic and nonpharmacologic therapies. Medications used include topical capsaicin and anesthetic agents, antiepileptic agents, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and atypical antipsychotic agents. Nonpharmacologic therapies such as psychotherapy and hypnosis have been beneficial. Further studies are needed, as most reports of efficacy are not evidence based.
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PMID:A practical review and update on the management of pruritus sine materia. 1885 58

It has been reported that 10-50% of patients with pruritus but no skin rash have an underlying systemic disease and up to 70% a psychiatric one. The aim of this retrospective study was to review the records of a large number of patients with chronic pruritus for concomitant diseases and treatment options. Medical records of 139 patients (52 males, 87 females) with chronic pruritus who visited the outpatient dermatological clinic during a 17-month period were reviewed. Itch was the presenting symptom in 6 of 47 patients with systemic disease and in 17 of 31 patients with psychiatric disease. Twenty-four patients had neuropathic itch and 37 patients had pruritus of unknown origin. The most severe and long-lasting itch was found in patients with multiple systemic diseases and in those with pruritus of unknown origin. Pruritus of the scalp and face was most common in psychogenic pruritus. Phototherapy was found to be a useful therapeutic option. In conclusion, systemic diseases are unlikely to cause chronic pruritus in patients consulting a dermatology department.
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PMID:Somatic and psychiatric comorbidity in patients with chronic pruritus. 2057 5

Skin diseases (atopic eczema, psoriasis, idiopathic urticaria), systemic diseases (chronic hepatic or renal failure, morbus Hodgkin, diabetes mellitus) and psychiatric disorders (obsessive compulsive disorders, depression, delusions of parasitosis) can occur with itching. The aim of this review is to clarify the link between pruritus and psychiatric morbidity and emphasize the importance of a psychiatric consultation for patients with a chronic itching, without a skin disease. In the last years, there is a growing awareness regarding psychogenic itch, although these types of itch are significantly less studied in comparison to other types of pruritus. Psychogenic pruritus is usually a diagnosis of exclusion. There are not controlled studies about treatment of psychogenic itch, but the same drugs prescribed for neuropathic pain, depression, and anxiety are used. There is a strong association between pruritus and psyche; so, it is important that the dermatologist evaluates psychosomatic dimension. According to the analysis of scientific literature and our clinical experience, pruritus seems to be a rather common phenomenon in patients suffering from depression. Future works should explain the basis of psychopathology of chronic itching thanks to studies of selected groups of patients with a particular type of chronic itching, highlighting the clinical features to establish appropriate and individual targeted care, based on the several types of pruritus. Some questions still unanswered could be clarified in this way. It is really important to decrease the symptoms "itching", because the quality of life of the patient will be improved, but the goal is to identify the underlying mechanisms of itch and establish a targeted therapy, depending on the biological changes and the underlying disease.
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PMID:Skin and brain: itch and psychiatric disorders. 2585 71

Pruritus is a bothersome and prevalent symptom reported by patients suffering from both cutaneous and extracutaneous diseases. Psychogenic pruritus, also referred to as functional itch disorder, is a distinct clinical entity. According to the definition proposed by the French Psychodermatology Group (FPDG) in 2007, the disorder is characterized by pruritus which is the chief complaint and psychologic factors that contribute to eliciting, worsening, and sustaining the symptoms. Specific diagnostic criteria were proposed, including 3 compulsory and 7 optional, of which 3 have to be met in order to establish the diagnosis. Psychogenic pruritus may require cooperation between dermatologists, psychiatrists, and psychologists. Psychotherapy and psychopharmacotherapy are mainstays of managing the disease. However, publications regarding psychogenic itch management are uncommon. Initially, general measures have to be taken, including avoiding irritating factors, preventing skin dryness, and frequent application of emollients. As in pruritus of other causes, several drugs are used, with more emphasis on substances that influence central nervous system: H1-antihistamines (hydroxyzine, chlorpheniramine, cyproheptadine, diphenhydramine, promethazine), tricyclic antidepressants (doxepin), tetracyclic antidepressants (mirtazapine), selective serotonin reuptake inhibitors (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline), antipsychotic drugs (pimozide), anticonvulsants (topiramate), and benzodiazepines (alprazolam), preferably depending on the coexisting symptoms.
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PMID:Psychogenic Itch Management. 2757 81

Chronic itching can be frustrating for patients and providers, and patients are not always willing to accept that their psychiatric health has an impact on their skin. Psychogenic pruritus is defined as itch not related to dermatologic or systemic causes. When a patient presents with pruritus, regardless of the presumed cause, the standard work-up should include a thorough history, dermatologic examination, and laboratory examinations or biopsies as needed. If no medical source is found, the provider must work in partnership with the patient to explore other causes and that may include acknowledging and treating underlying psychiatric conditions.
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PMID:Psychogenic Pruritus and Its Management. 2992 2

Chronic pruritus (CP) can occur in the absence of skin diseases, and may be secondary to various causes. The aim of this study was to retrospectively analyse the causes of CP without skin disease in a cohort of patients from the dermatology department, including all patients hospitalized for management of their CP between 2008 and 2018. A total of 197 patients with CP without skin disease were included, mean age 66.7 years, 50.8% men. The main causes identified were psychogenic pruritus (41.1% of patients), neuropathic (36.5%), endocrine (12.2%), haematological (9.6%) and iatrogenic (7.1%) causes. The cause was unknown in 20.8% of patients. Total percent is more than 100 because some patients had several etiologies. Only one aetiology of CP was identified in most patients (69.5%), and 2 aetiologies (in 18.3%) or more (in 12.2%). Concerning symptomatic treatments, emollients were prescribed for 40.6% of patients and topical steroids for 20.3%. Among systemic treatments, gabapentinoids (33%), antidepressants (27.4%) and antihistamines (25.3%) were prescribed. The efficacy of these treatments was rarely complete.
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PMID:Chronic Pruritus in the Absence of Skin Disease: A Retrospective Study of 197 French Inpatients. 3292 77


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