Endless itch Flashcards

1
Q

History of itch

A
what came first rash or itch - if itch more likely systemic, neuropathic, psychogenic cause 
timing and distribution of itch
specific areas or all over
DH - any causes
SH 
focused SI
any fevers - travel history
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2
Q

pruritus

A

itching without a rash

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3
Q

prurigo

A

intensely itchy papules and nodules

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4
Q

chronic pruritus

A

itching >6 weeks

can lead to secondary skin lesions including, excoriations, lichenification and hyper pigmentation

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5
Q

non skin causes of widespread rash

A

psychogenic - parasitophobia, OCD, depression, anxiety
neurological - peripheral neuropathy, MS, post herpetic neuropathy
thyroid - hyper thyroid
CKD
DM
GI - cholestasis
malignancy and haematological - Hodgkins lymphoma, myeloid and lymphatic leukaemia, solid malignant tumours, polycythaemia rubra vera,
multisystem: inflammation, infection - dermatomyositis, scleroderma, HIV, Hep C

Drugs

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6
Q

examination in wide spread itch

A

nails and hair: clubbing (IBD, liver cirrhosis, congenital heart disease), splinter haemorrhages, palmar erythema, nail fold telangiectasia, loss of hair or hirsutism
GI: hepatomegaly, splenomegaly, abdominal masses
CVS: murmur
Resp: abnormal breath sounds
haematological: lymphadenopathy
neurological: limb weakness, facial asymmetry, cognition

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7
Q

investigations in wide spread itch

A
ESR
FBC
TFT
U&Es
HIV serology
random glucose
CXR
serum immunoglobulins and electrophoresis
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