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

Based on experiences in homes for the aged in Singapore, the following may be useful guidelines when dealing with dermatological cases in old people: Diagnosis can be difficult: common diseases come first. The clinical picture is often altered by the patient's self-medication: search for the primary disease. Expect considerable interference of your therapy by other medication. Keep therapy as simple as possible. Refrain from oral medication. Scabies is more common than usually thought and often difficult to recognize when the general standard of hygiene is high. Creams and ointments are not helpful in stasis eczema and leg ulcers. Diuretics often do not work in ankle oedema and its skin complications. Compressive bandages or elastic stockings are cheaper and safer. Antihistaminics rarely work to relieve itch, but cause considerable drowsiness. Use them only for urticaria. Many elderly have a dry skin: soap can cause itch and dermatitis.
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PMID:Skin problems in the aged. 359 1

Aquagenic pruritus is now a well-recognized symptom complex, usually of unknown origin. A few prove to have polycythemia rubra vera. We describe an important and distinct subset, termed aquagenic pruritus of the elderly, in which old age, dry skin, and seasonal weather conditions are major factors. Unlike other varieties, aquagenic pruritus of the elderly responds to appropriate local measures.
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PMID:Water-induced itching without cutaneous signs. Aquagenic pruritus. 394 25

Ten women with essential hirsutism were treated for one year with cyclic administration of cyproterone acetate and ethinyl estradiol. Biochemical and clinical control took place after 1, 3, 6 and 12 months of treatment. In 4 patients great improvement of hirsutism was noted, but only after 6 months of therapy. In 4 patients there was some improvement, while 2 were resistant. Side effects included reduced libido in 4 cases, mental depression in 3, dry skin and itching in 4 and transient nausea in one, but never necessitated cessation or interruption of treatment. Several changes in endocrine function took place during treatment: testosterone secretion rate diminished together with the urinary excretion of 17-KS and 17-KGS, while the serum concentration of testosterone binding globulin increased. There was a reduction in the serum concentration of total endogenous estrogens and progesterone as well as LH. No changes in hepatic, renal or hematologic parameters were found except for a slight increase in plasma prothrombin time. Clinical outcome of therapy could not be correlated with a pretreatment endocrine "profile", nor with the changes that this therapy induced in endocrine function. It is concluded that the anti-androgenic effect is probably the most important in this drug regimen, but that reversibility of hirsutism may depend upon factors not directly related to androgen influence.
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PMID:The treatment of essential hirsutism in women with cyproterone acetate and ethinyl estradiol. Clinical and endocrine effects in 10 cases. 645 99

In order to qualify as a case of atopic dermatitis, we propose that an individual must have an itchy skin condition plus three or more of the following: history of flexural involvement, a history of asthma/hay fever, a history of a generalized dry skin, onset of rash under the age of 2 years, or visible flexural dermatitis. When tested in an independent sample of 200 consecutive dermatology outpatients of all ages, this arrangement of the diagnostic criteria achieved 69% sensitivity and 96% specificity when validated against physician's diagnosis. Based on the findings of this first exercise, minor modifications in the wording of the criteria were undertaken, and these were tested on a sample of 114 consecutive children attending out-patient paediatric dermatology clinics. Overall discrimination improved, with a sensitivity of 85% and specificity of 96%. The simplified criteria are easy to use, take under 2 min per patient to ascertain, and do not require subjects to undress. These two independent validation studies suggest that the newly proposed criteria for atopic dermatitis perform reasonably well in hospital out-patient patients. Further validation in community settings and in developing countries is needed.
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PMID:The U.K. Working Party's Diagnostic Criteria for Atopic Dermatitis. III. Independent hospital validation. 791 17

Omeprazole is a substituted benzimidazole that has gained widespread use in the treatment of acidic and peptic ulcer disease. Adverse events with the drug are rare and involve mainly the gastrointestinal and central nervous systems. Skin inflammation, urticaria, pruritus, alopecia, and dry skin have been reported in 0.5-1.5% of patients. To date, no published report has linked angioedema with omeprazole. We report a case of a 34-year-old woman with cellulitis, ulcerative erosive esophagitis, and gastric and duodenal ulcers who developed several hypersensitivity reactions characterized by shortness of breath, wheezing, cough, mild angioedema, and total body urticaria and pruritus. These symptoms correlated with the addition of omeprazole to her regimen and the timing of its administration. A previous case report prompted a rechallenge with enteric-coated omeprazole granules removed from the capsule shell. Recurrence of the adverse events suggested an allergy to the drug itself and not the capsule. Angioedema can be a life-threatening allergic reaction requiring immediate treatment. Rechallenge using omeprazole with or without the capsule shell should be done only in a hospital setting where prompt action can be taken in the event of an emergency.
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PMID:Angioedema and urticaria associated with omeprazole confirmed by drug rechallenge. 815 96

To study the prevalence and pathogenesis of uremic pruritus, CAPD and HD patients were asked to complete a questionnaire. The replies were quantitated based on numerical scales, and the results were compared with various hematological and biochemical parameters, underlying disease, and duration of dialysis. There were 113 CAPD patients (63 males and 50 females), mean age 60 (range 20-84) years, average time on CAPD 20 (range 1-163) months and 76 HD patients (44 males and 32 females) mean age 57 (range 23-81) years, mean time on HD 44 (range 2-242) months. Replies to questions were evaluated and graded by the same investigator who did not know the patients. Pruritus was present in 70 (62%) CAPD patients (64% in females and 60% in males p = NS) and in 41 (54%) HD patients (69% in females and 43% in males, p = 0.025). Before starting dialysis pruritus was present in 30% CAPD patients and 28% HD patients. Pruritus was graded as mild, moderate and severe; the distribution was 58.6%, 34.3%, and 7.1% (CAPD) and 43.9%, 41.5%, and 14.6% (HD), respectively. Dry skin was reported by 73% CAPD patients and 72% HD patients. This xeroderma was correlated with the severity of pruritus and was also present in 65% CAPD and 48.5% HD patients without pruritus. Patients with pruritus were older than those without pruritus both for CAPD (63 vs 54 years, p = 0.004) and HD (61 vs 51 years, p = 0.003). A significant correlation was observed only between pruritus score and age for CAPD patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pruritus in continuous ambulatory peritoneal dialysis and hemodialysis patients. 839 56

The aetiology and the pathophysiological mechanisms underlying the development of dry skin in uraemia are still unclear, but the hydration status of stratum corneum clearly influences the appearance of skin. The xerotic skin texture is often referred to as 'dry skin' and has been suggested as a cause of uraemic pruritus. To understand the aetiology of dry skin in uraemia we measured the status of skin surface hydration of uraemic patients with the corneometer and skin surface hydrometer, the functional capacity and the urea concentration of stratum corneum and the response of eccrine sweat gland to sudorific agent (0.05% pilocarpine HCL) in 18 age-matched haemodialysis patients and 10 healthy volunteers. We also performed the water sorption-desorption test to uraemic and control subjects after application of urea in various concentrations. Uraemic patient's skin showed decreased water content compared to control subjects. However, we found no correlation between dry skin and pruritus. Although the urea concentration of the horny layer in uraemic patients was elevated compared to control subjects (28.2 microgram/cm2 vs 5.04 micrograms/cm2, P < 0.05), its moisturizing effect to relieve pruritus is questionable because its artificial application revealed no improvement of the functional capacity of horny layer in concentration 5 times higher than the physiological concentration. Uraemic patients showed decreased sweating response to sudorific agent. In conclusion, the functional abnormalities of eccrine sweat glands may be account for dry skin in uraemic patients at least in part, but there is no correlation between xerosis and pruritus.
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PMID:Dry skin (xerosis) in patients undergoing maintenance haemodialysis: the role of decreased sweating of the eccrine sweat gland. 880 24

In recent years, interferon-alpha has become widely used for systemic therapy of tumours and infectious diseases. Well-known cutaneous side effects include dry skin, pruritus and hair loss. Since 1986, 17 patients with renal cell carcinoma, malignant melanoma, hepatitis B and C, carcinoid syndrome and hairy cell leukemia have been reported in whom psoriasis with or without psoratic B joint involvement was induced or exacerbated by systemic interferon-alpha therapy. In these patients, the drug was discontinued because of the severity of the psoriatic symptoms induced. The psoriatic lesions then resolved in nearly all patients within 2 weeks to 6 months, but in 10 of 22 patients treated with interferon-alpha specifically for psoriasis exacerbation was reported. We report three new cases of interferon-alpha-induced psoriasis. The patients were treated with the drug for HIV-associated Kaposi's sarcoma, renal cell carcinoma, and hepatitis C. We conclude that interferon-alpha can provoke psoriatic skin and joint symptoms, especially when additional precipitating factors are involved. In patients in whom such risks are present careful consideration of the benefit/risk ratio and concomitant antipsoriatic treatment are essential if interferon-alpha therapy is to be continued.
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PMID:[Interferon-alpha-induced psoriasis vulgaris]. 886 56

In an open multicentre drug monitoring survey, 1611 patients with atopic dermatitis, contact eczema, dry eczema, psoriasis and pruritus were treated with a preparation containing 5% urea and 3% polidocanol (laurylmacrogol). To monitor the course of treatment, three examinations were performed, one at the start of therapy and two more at intervals of approximately two weeks. A marked improvement in the status of the skin was observed during treatment. A marked regression occurred in the principal signs of dry skin--scaling, dryness and roughness. Troublesome itching was also greatly reduced. Almost half of the patients (48.9%) were free of itching at the end of the observation period. Adverse drug effects arose in only 2.8% of cases, and were mostly smarting, itching and irritation. No intolerance reactions were observed in children under six years. At the end of the observation period the skin status was judged, by both the doctors and the patients as 'good' or 'very good' in almost 90% of cases. Furthermore, the assessment with regard to the regression of itching was almost identical.
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PMID:Results of a postmarketing drug monitoring survey with a polidocanol-urea preparation for dry, itching skin. 916 55

Atopic dermatitis (AD) is a chronic inflammatory skin disease with the principal symptoms of dry skin, lichnification, eczematous inflammation, and an intense pruritus. Despite general acceptance that AD is a multifactorial skin disorder, dysregulation of immune functions (e.g., hypersecretion of immunoglobulin-E, altered cytokine profiles) is considered to be mainly involved in AD pathogenesis. Considerable evidence points to an immunoregulatory function for the hypothalamus-pituitary-adrenal (HPA) axis, suggesting that appropriate reactivity of the HPA axis is necessary to prevent the immune system from reaching a level that may be damaging for the host. It is further hypothesized that dysfunctional reactivity of the HPA axis may increase the vulnerability of the organism to immune-related disorders such as inflammatory diseases. In the present paper the role of the HPA axis for the development and chronification of allergic inflammation will be summarized and the potential pathological significance of a dysfunctional HPA axis in AD pathogenesis will be discussed.
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PMID:Altered reactivity of the hypothalamus-pituitary-adrenal axis in patients with atopic dermatitis: pathologic factor or symptom? 962 1


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