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afya
Pruritis
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<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> may be caused by - skin disease, systemic disease, nerve damage, psychiatric, drugs usually - dry skin, contact dermatitis, atopic dermatitis secondary lesions - excoriation, lichenification, prurigo nodules, hyperpigmentation (hypo in dark skin), bruising Chronic itch >6/52 Clinically Need good Hx - duration, localisation, intensity, sleep, exacerbate/relieve, atopy, travel, drugs Good skin care impt Systemic CKD, Cholestasis, Hyperthyroid, ...... Ix ??Bx - if rash FBC, LFT, U/E, TFT, Haematinics Mx - best to treat cause emollients / barriers preventive measures - clothing, avoid soaps etc steroids - topical or oral - relieve itch associated with inflammation antihistamines - relieve itch caused by histamine, topical - limited use, sedating and non-sedating SSRI, Gabapentin Pregabalin ..... Immunomodulators (Tacrolimus) - useful but also cause burning and systemic ones Counterirritants - capsaicin topical anaesthetics topical salicylates - with lichen simplex Opiates - Naltrexone Phototherapy CBT / CAM Specific suggestions - looks useful Complications disturbs - sleep, concentration, libido agitation / depression
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Dermatology