Chronic Pruritus Without Skin Rash– Evaluation of Systemic Causes

Abstract

BACKGROUND Pruritus lasting more than 6 weeks is termed chronic pruritus. Certain systemic diseases have long been known to cause pruritus that ranges in intensity from a mild annoyance to an intractable, disabling condition. Generalized pruritus may be classified into the following categories on the basis of the underlying causative diseases like renal pruritus, cholestatic pruritus, haematologic pruritus, endocrine pruritus, pruritus related to malignancy and idiopathic generalized pruritus. The aim of this study was to evaluate the systemic causes of chronic pruritus without skin rashes. MATERIALS AND METHODS A descriptive cum analytical study was performed for a period of nine months duration. Inclusion Criteria-Pruritus of more than six weeks duration without skin rash: female and male of any age group are included in this study. Exclusion Criteria-Patients with skin rashes are not included in this study. All patients were evaluated with history and complete physical examination. Blood investigations like complete blood count, blood sugar, renal function test, liver function test and peripheral smear study were done for all patients. Investigations for thyroid disorders and haematologic causes were done for required patients. USG abdomen and CT scan were also done for required patients. Expert's opinion obtained for those patients having psychological and neurological signs and symptoms. RESULTS For a period of nine months duration 100 patients were evaluated and tabulated. By this study, various systemic diseases were diagnosed and treated. For further evaluation and treatment certain patients were referred to other speciality departments. Limitations-A small number of patients during this period was a limiting factor. CONCLUSION By evaluating the systemic causes of chronic pruritus without skin rash, hidden cases can be brought out and it helps for the treatment purpose also.