Diabetes and pruritus

Abstract

Pruritus is often reported to be associated with diabetes mellitus although this remains controversial. Careful historytaking and examination are key to establishing the cause of itching in a patient with diabetes after excluding local cutaneous disease or an underlying lymphoma. Options for management of this distressing condition include emollients, topical antipruritic agents (e.g. calamine, menthol, capsaicin, corticosteroids, calcineurin inhibitors or local anaesthetics), systemic antipruritic agents (e.g. H1 antihistamines, doxepin and gabapentin), broad-band or narrowband ultraviolet B phototherapy and psychological therapies. Br J Diabetes 2016;16:154-155

Chronic Pruritus Without Skin Rash– Evaluation of Systemic Causes

“…21 Metabolic abnormalities, autonomic dysfunction, anhydrosis and diabetic neuropathy all may contribute to generalised pruritus. 20 The prevalence of iron deficiency anaemia was 11% according to our study. In that 3% of patients were associated with systemic diseases like hypothyroidism, diabetes and chronic renal disease.…”

“…19 Pruritus is often associated with diabetes mellitus although this is remaining controversial. 20 As per Al-Mutairi et al study the prevalence of pruritus among diabetic patients was 49%. A study in elderly subject showed diabetes to be a statistically significant predictor of pruritus.…”

“…In contrast, one study showed that generalized pruritus of unknown cause was especially common in patients with diabetes (8/300). 20 Ko et al studied the link between glycemic control and generalised pruritus in 385 patients with type 2 diabetes. A significant number of patients (27.5%) suffered from pruritus resulting in sleep disturbance.…”

“…A significant number of patients (27.5%) suffered from pruritus resulting in sleep disturbance. 20 Generalised pruritus was once considered a typical symptom of diabetes but its frequency is unknown. Studies have failed to provide a statistical basis for this belief.…”

Aquagenic Pruritus in Polycythemia Vera: Clinical Characteristics

“…The mean AP intensity evaluated with VAS (4.8 ± 1.9 points) was lower in comparison with pruritus observed in common dermatoses, such as atopic dermatitis (7.9 ± 2.2 points) (13), chronic urticaria (7.5 ± 1.8 points) (24) or lichen planus (6.5 ± 2.7 points) (25). However, with regard to other internal diseases, such as uraemic pruritus (4.1 ± 2.0 points) (26) or diabetes mellitus (4.7 ± 2.8 points) (27), the severity of AP appears to be comparable. Considering the assessments conducted with 4-item Itch Questionnaire, in opposition to other diseases presenting similar symptoms, such as atopic dermatitis (14.0 ± 4.4 points) (13) or uraemic pruritus (8.2 ± 4.5 points) (15), the mean results for AP were somewhat lower (6.0 ± 2.9 points).…”