Itchingrelated

Itching-related refers to conditions and symptoms in which pruritus, the sensation of itch, is a prominent feature. Pruritus can be localized or widespread, acute or chronic, and may occur with visible skin changes or in the absence of a rash. It often disrupts sleep and daily activities and can lead to scratching that damages the skin.

Causes are diverse and commonly grouped into dermatologic, systemic, neuropathic, and psychogenic categories. Dermatologic causes include eczema, dermatitis, psoriasis, fungal infections, scabies, and urticaria. Systemic causes encompass liver or kidney disease, cholestasis, iron deficiency anemia, thyroid disorders, diabetes, certain cancers, and infections. Neuropathic pruritus arises from nerve damage or central nervous system disorders, such as postherpetic itch, diabetic neuropathy, or multiple sclerosis. Psychogenic itch refers to itch without an identifiable skin disease, often associated with stress, anxiety, or psychiatric conditions. Medications, including some opioids and other drugs, can also induce or worsen itching.

Evaluation relies on a careful history and physical examination to identify potential underlying conditions. Tests may include blood counts, liver and kidney function tests, thyroid studies, iron studies, and skin scrapings or biopsies when indicated. In older adults or new, persistent, or widespread itching, clinicians assess for systemic disease or malignancy.

Management targets both the underlying cause and symptom relief. Emollients and skin-directed therapies help with dry skin conditions; topical steroids or calcineurin inhibitors address inflammatory dermatoses. Antihistamines may offer limited relief; gabapentinoids, antidepressants, or other systemic agents can aid chronic pruritus. In refractory cholestatic pruritus, therapies such as rifampin or bile acid sequestrants may be used. Behavioral strategies to reduce scratching and improve sleep are often beneficial.