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Pruritis (Itch) - Pruritis Ani causes, symptom, treatment
What is Pruritis Ani?
Pruritis is associated with underlying systemic illnesses or a bothersome itch. Pruritis is the name for itchiness that causes pets to scratch. Pruritis is a common and often challenging adverse effect of hemodialysis, often occurring in patients who already have uremia-associated pruritis to be begin with. Pruritis, or generalized itch, is a source of serious discomfort and distress in a significant minority of people living with AIDS.
What causes Pruritis Ani ?
The exact cause of an itch is unknown and is a complex process.
Pruritis is frequently a difficult problem both in establishing a cause and treating effectively. However, several characteristics you describe narrow down the etiologic possibilities of Pruritis somewhat:
- The absence of rash generally rules out a primary skin problem, although occasionally itching / Pruritis precedes certain rashes by weeks to months. For example, T cell lymphomas of skin may not be apparent on gross examination for awhile but are detected by biopsies.
- The good response to antihistamines rules against a primary "central" neurologic problem causing the itch.
- Other historical factors are helpful - itching / Pruritis that lasts more than several weeks and is extensive (on many regions of the body) is more suggestive of a systemic process causing the itch than a localized itch. Once systemic conditions are considered, they can be divided into these categories with diagnostic approaches:
- Chronic renal failure - check BUN, creatinine
- Hepatic cholestasis, check bilirubin, LFT
- Hemopoietic disorders - P. vera, paraproteinemia - Check CBC, SPEP.
- Endocrine disorders, hyperthyroid, diabetes mellitus, carcinoid - Check TSH, T3, T4, glucose, 5HIAA
- Drug reaction - check history carefully with Pruritis. There is not always a rash. For example, some drug reactions cause cholestasis.
- Systemic parasitosis-particularly important in this case of a man originally from Africa.Possibilitity increases if there is blood eosinophilia.Most likely possibilities in severe itch- ascaris scabies, trichinella, onchocerciasis, Check stools, look for burrows under skin, particularly on hands.
- Certain malignancies - lymphoma, myeloma, M. fungoidies more than typical epidermoid tumors.
- Psychogenic - neurotic excoriations, delusions of parasitosis .
- Miscellaneous - mastocytosis, hemochromatosis, AIDS.
Pruritis Classification as skin diseases:
Pruritis is a feature of many of skin diseases. Generalized Pruritis can precede some skin disease such as pemphigoid. Some common skin diseases causing itchiness is listed as follows:
| Severe |
Moderate |
- Scabies, pedulosis
- Insect bites
- Contact dermatitis
- Atopic eczema
- Urticaria
- Miliaria
- Lichen planus
- Dermatitis herpetiformis
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- Psoriasis
- Seborrhoeic eczema
- Fungal infection
- Dry skin
- Sunburn
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Pruritis Ani Treatment
Pruritus ani is frequently stubborn and requires months of local medication and gentle skin care. Medications which have been succesful for this condition include: - Lotrimin cream mixed with hydrocortisone 1% cream applied daily. Both of these are available over the counter at your local drug store. - A mild alpha hydroxyacid applied each day. - Plain vaseline applied each day to the anal area.
Recovery from Pruritis
Most people experience some relief from itching within a week. Complete cure usually comes within four to six weeks.
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