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Ferreira, Bárbara R., i Laurent Misery. "Psychopathology Associated with Chronic Pruritus: A Systematic Review". Acta Dermato-Venereologica 103 (22.08.2023): adv8488. http://dx.doi.org/10.2340/actadv.v103.8488.
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There are no previous studies of the psychopathology associated with different aetiologies of chronic pruritus. A systematic review was performed of cohort and case-control studies comparing healthy controls with patients with chronic pruritus related to primary dermatoses, systemic diseases, psychogenic pruritus, idiopathic pruritus, prurigo nodularis and/or lichen simplex chronicus. The review was registered in PROSPERO and performed according to the PRISMA statement, which allowed the inclusion of 26 studies. The quality of eligible studies was assessed using the modified Newcastle-Ottawa Scale. Most of the studies concern primary dermatoses and systemic diseases. Sleep disorders are a common comorbidity interrelated with pruritus, anxiety and depressive symptoms, in primary dermatoses. Sleep disorders are linked with pruritus and depressive symptoms in end-stage renal disease and hepatobiliary disease. Depressive and anxiety symptoms are associated with psychogenic pruritus. Psychogenic pruritus, lichen simplex chronicus and some primary dermatoses are linked with personality characteristics. Further studies are required to explore in depth the psychopathology linked with psychogenic pruritus and prurigo nodularis, as well as psychopathology linked with other primary dermatoses and systemic disorders associated with chronic pruritus, and to better differentiate psychogenic pruritus from psychopathological characteristics linked with other aetiologies of chronic pruritus, in order to improve the management of patients with chronic pruritus.
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Tareen, Attiya, Irfan Ullah, Ammara Safdar, Hadia Yaqub Khan, Uzma Rajar i Habiba Yaqub Khan. "Generalized Pruritus: An Etiological Breakup of 700 patients presenting to dermatology opd of a local hospital." BMC Journal of Medical Sciences 3, nr 2 (13.01.2023): 65–69. https://doi.org/10.70905/bmcj.03.02.049.
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Background: Pruritus is an itching sensation or a constant urge to itch over skin that may be localized in response to a local stimulus or generalized due to an underlying condition with or without presence of causative agent. It can be caused by dermatological or systemic conditions, iatrogenic or as a response to external substances such as parasites. Generalized pruritus may not be necessarily due to dermatological causes and systemic, neurologic, endocrinologic, and psychogenic conditions may have pruritus as a primary cutaneous manifestation. Skin conditions like Scabies, eczema and airborne dermatitis are commonly incriminated as reason for intense itching and so lab workup or clinical examination and history taking is often omitted, in our busy outdoors. Therefore, the purpose of this study is to rule out underlying common systemic diseases like hypothyroidism, diabetes mellitus and chronic renal and liver disease as cause of severe generalized pruritus. Objective: To identify the underlying cause of generalized pruritus in patients presenting to dermatology outdoor excluding pruritic dermatological diseases. Methodology: This is a cross-sectional observational study conducted on 700 patients from January 2018 to October 2021, in Fauji Foundation hospital Rawalpindi. Patients between the ages of 15 to 69 years visiting dermatology OPD of the department with complaints of generalized pruritus, who were recruited for the study after filling the consent form. Clinical investigations (Blood Cp, LFTS, RFTs, TFTs) and past medical history were taken to identify the underlying cause of pruritus was conducted and diagnoses were documented Only the patients who were having non dermatological causes were included in the study and the diagnoses were further categorized as idiopathic, systemic, endocrinological, neurogenic, psychogenic and drug induced. Results were compiled and analyzed using SPSS version 22. Results: The results of this study show that 700 participants with mean age of 47.39, out of which 110 were males and 590 were females had generalized pruritus. Out of them, 126 (19%) had pruritus due to chronic renal disease, 119(17%) had chronic liver disease, 63 (9%) had diabetes mellitus, 42 (6%) had paraneoplastic, 126(18%) senile pruritis, 35(5%) had cholinergic pruritus,21 (3%) iron deficiency anemia. 14(2%) had atopic dermatitis of elderly. Drug induced pruritus 56(8%). Conclusion: Pruritus without known pruritic dermatoses is a common presenting complaint in patients presenting to outdoors having one of the underlying systemic disease. Further work is needed to evaluate impact of pruritus on quality of life in these already diseased patients.
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Заславский, Д. В., А. А. Трещевская, А. В. Соболев, С. В. Скрек, А. А. Сыдиков, М. И. Зелянина, О. Л. Заславская i in. "Lichenoid Reaction vs Psychogenic Pruritus". Дерматовенерология Косметология, nr 1-2 (27.05.2020): 89–103. http://dx.doi.org/10.34883/pi.2020.1.6.012.
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В статье описаны ключевые звенья патогенеза медикаментозной лихеноидной реакции, а также отражена современная концепция межклеточного взаимодействия с развитием аутоиммунного воспаления в коже. Определена роль лекарственных препаратов в патогенезе развития лихеноидной реакции, указаны наиболее типичные молекулы, вызывающие парадоксальные реакции макроорганизма, объяснена роль полипрагмазии.Очевидным фактом, вытекающим из повествования статьи, является необходимость и значимость проведения соматического, психоневрологического, дерматоскопического и патоморфологического исследований у пациентов с кожным зудом. Приведен случай собственного клинического наблюдения у пациентки, длительно страдающей тяжелой формой лихеноидной реакции, которая впоследствии сформировала целый симптомокомплекс генерализованного тревожного расстройства, способствовала возникновению суицидальных мыслей и, как следствие, привела к госпитализации пациентки в психиатрическую больницу. Особое внимание уделяется описанию клинических проявлений лихеноидной реакции и дифференциальной диагностике с другими дерматозами. The article describes the key links in pathogenesis of drug lichenoid reaction, and also reflects the modern concept of cell-cell interaction with the development of autoimmune inflammation in the skin. The role of drugs in the pathogenesis of lichenoid reaction is determined, the most typical molecules causing paradoxical reactions of the macroorganism are indicated and the roleof polypharmacy is explained. The obvious fact arising from the story of the article is the need and significance of conducting somatic, psychoneurological, dermatoscopic, and pathomorphological studies in patients with itchy skin. We report a case in a young patient who was suffering from a severe form of lichenoid reaction for a long time, which subsequently formed a whole complex of psycho-emotional disorders, contributed to the emergence of suicidal ideas and, as a result, led the patient to hospitalization in the psychiatric ward. Particular attention is paid to the description of the clinical manifestations of lichenoid reaction and differential diagnosis with other dermatoses.
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Buteau, Anna, i Jason Reichenberg. "Psychogenic Pruritus and Its Management". Dermatologic Clinics 36, nr 3 (lipiec 2018): 309–14. http://dx.doi.org/10.1016/j.det.2018.02.015.
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Misery, Laurent. "Functional itch disorder or psychogenic pruritus". Expert Review of Dermatology 3, nr 1 (luty 2008): 49–53. http://dx.doi.org/10.1586/17469872.3.1.49.
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Tey, Hong Liang. "Epidermolysis Bullosa Pruriginosa Masquerading as Psychogenic Pruritus". Archives of Dermatology 147, nr 8 (1.08.2011): 956. http://dx.doi.org/10.1001/archdermatol.2011.189.
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Damayanti. "Pruritus in elderly: Classification and management". World Journal of Advanced Research and Reviews 21, nr 1 (30.01.2024): 254–59. http://dx.doi.org/10.30574/wjarr.2024.21.1.2637.
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Pruritus is majority complaint that is often encountered in dermatology. The diagnosis and management of pruritus still became important health problem in elderly. It is estimated that one fifth of the world’s population experience chronic pruritus which can affect their quality of life. The lifetime prevalence of chronic pruritus in the general population was 22%. In the elderly, two thirds of the population are reported to experience pruritus. Based on the onset of symptom, pruritus is divided into acute pruritus and chronic pruritus. While based on clinical complaints, pruritus is divided into pruritus originating from the skin, neuropathic pruritus, neurogenic pruritus, and psychogenic pruritus. Elderly skin is sensitive skin, which often gives complaints of itching. Pruritus, especially in elderly, requires treatment that must be adapted to the pathophysiology. Treatment of pruritus in the elderly can include topical therapy, systemic therapy and phototherapy. The management approach to pruritus consists of 4 important pillars, namely basic therapy, targeted therapy, symptomatic therapy, and therapy for accompanying diseases.
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Chung, Bo Young, Ji Young Um, Jin Cheol Kim, Seok Young Kang, Chun Wook Park i Hye One Kim. "Pathophysiology and Treatment of Pruritus in Elderly". International Journal of Molecular Sciences 22, nr 1 (26.12.2020): 174. http://dx.doi.org/10.3390/ijms22010174.
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Pruritus is a relatively common symptom that anyone can experience at any point in their life and is more common in the elderly. Pruritus in elderly can be defined as chronic pruritus in a person over 65 years old. The pathophysiology of pruritus in elderly is still unclear, and the quality of life is reduced. Generally, itch can be clinically classified into six types: Itch caused by systemic diseases, itch caused by skin diseases, neuropathic pruritus, psychogenic pruritus, pruritus with multiple factors, and from unknown causes. Senile pruritus can be defined as a chronic pruritus of unknown origin in elderly people. Various neuronal mediators, signaling mechanisms at neuronal terminals, central and peripheral neurotransmission pathways, and neuronal sensitizations are included in the processes causing itch. A variety of therapies are used and several novel drugs are being developed to relieve itch, including systemic and topical treatments.
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Silvestri, Silvestri, i Anggraeni Noviandini. "A Literature Review of Pruritus in Elderly". Asian Journal of Engineering, Social and Health 2, nr 10 (13.10.2023): 1086–101. http://dx.doi.org/10.46799/ajesh.v2i10.142.
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Pruritus is a relatively common symptom that anyone can experience at any point in their life and is more common in the elderly. Pruritus in elderly can be defined as chronic pruritus in a person over 65 years old. The pathophysiology of pruritus in elderly is still unclear, and the quality of life is reduced. Generally, itch can be clinically classified into six types: Itch caused by systemic diseases, itch caused by skin diseases, neuropathic pruritus, psychogenic pruritus, pruritus with multiple factors, and from unknown causes. Senile pruritus can be defined as a chronic pruritus of unknown origin in elderly people. Various neuronal mediators, signaling mechanisms at neuronal terminals, central and peripheral neurotransmission pathways, and neuronal sensitizations are included in the processes causing itch. A variety of therapies are used and several novel drugs are being developed to relieve itch, including systemic and topical treatments.
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Georgieva, Filka. "Pruritoceptive and psychogenic pruritus in lichen simplex chronicus". Scripta Scientifica Medica 48, nr 2 (6.06.2016): 55. http://dx.doi.org/10.14748/ssm.v48i2.1572.
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Gupta, Madhulika A., Aditya K. Gupta, Sueann Kirkby, Nicholas J. Schork, Howard K. Weiner, Charles N. Ellis i John J. Voorhees. "Pruritus associated with nocturnal wakenings: Organic or psychogenic?" Journal of the American Academy of Dermatology 21, nr 3 (wrzesień 1989): 479–84. http://dx.doi.org/10.1016/s0190-9622(89)70211-5.
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Bernhard, Jeffrey D. "Nocturnal wakening caused by pruritus: Organic or psychogenic?" Journal of the American Academy of Dermatology 23, nr 4 (październik 1990): 767. http://dx.doi.org/10.1016/s0190-9622(08)81086-9.
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Chen, KS, i PD Yesudian. "Pruritus in older people". Reviews in Clinical Gerontology 23, nr 1 (29.01.2013): 1–14. http://dx.doi.org/10.1017/s0959259812000214.
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SummaryPruritus in older people is caused by a wide range of dermatological, systemic, neurological and psychogenic diseases. It can also be attributed to various cutaneous drug reactions. The dermatological, neurological and immunological changes associated with ageing predispose older people to pruritus of a wide range of aetiologies. The most common cause of pruritus in older people is xerosis, or dry skin. Regular use of emollients is the mainstay of treatment for pruritus of any cause, with general measures aiming to ensure optimal skin hydration and to prevent the itch–scratch cycle. Topical treatments are generally better tolerated for localized pruritus. Anti-histamines are the predominant agents to treat pruritus, but can be inadequate in many cases. Numerous other systemic agents have been demonstrated to alleviate pruritus depending on the cause, but may be limited by their adverse effects. This article reviews the current published literature on pruritus in older people, with a practical approach to its evaluation and management in non-specialist settings.
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Fried, Richard G. "Evaluation and treatment of “psychogenic” pruritus and self-excoriation". Journal of the American Academy of Dermatology 30, nr 6 (czerwiec 1994): 993–99. http://dx.doi.org/10.1016/s0190-9622(94)70125-3.
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Gupta, M. A. "Evaluation and treatment of “psychogenic” pruritus and self-excoriation". Journal of the American Academy of Dermatology 32, nr 3 (marzec 1995): 532–33. http://dx.doi.org/10.1016/0190-9622(95)90107-8.
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Rattanakaemakorn, Ploysyne, i Poonkiat Suchonwanit. "Scalp Pruritus: Review of the Pathogenesis, Diagnosis, and Management". BioMed Research International 2019 (15.01.2019): 1–11. http://dx.doi.org/10.1155/2019/1268430.
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Scalp pruritus is a frequent problem encountered in dermatological practice. This disorder is caused by various underlying diseases and is a diagnostic and therapeutic challenge. Scalp pruritus may be localized to the scalp or extended to other body areas. It is sometimes not only associated with skin diseases or specific skin changes, but also associated with lesions secondary to rubbing or scratching. Moreover, scalp pruritus may be difficult to diagnose and manage and may have a great impact on the quality of life of patients. It can be classified as dermatologic, neuropathic, systemic, and psychogenic scalp pruritus based on the potential underlying disease. A thorough evaluation of patients presenting with scalp pruritus is important. Taking history and performing physical examination and further investigations are essential for diagnosis. Therapeutic strategy comprises removal of the aggravating factors and appropriate treatment of the underlying condition. All treatments should be performed considering an individual approach. This review article focuses on the understanding of the pathophysiology and the diagnostic and therapeutic management of scalp pruritus.
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Dorozhenok, I. Yu, E. S. Snarskaya i М. Mikhailova. "Psychosomatic disorders associated with pruritus in patients with lichen planus (review)". Russian Journal of Skin and Venereal Diseases 23, nr 1 (2.08.2020): 42–49. http://dx.doi.org/10.17816/dv2020142-49.
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This review examines the psychosomatic aspects of pruritus in dermatological practice, as well as chronic dermatoses associated with pruritus of psychosomatic disorders in a lichen planus model. As the leading nosogenic factor, skin itching is involved in the development of psychogenic, neurotic, and depressive disorders. Notably, psychosomatic disorders associated with itching form various comorbidities with phenotypic manifestations of lichen planus. The introduction of an integrated multidisciplinary approach into the clinical practice, with the inclusion of psychocorrectional techniques in basic dermatological treatment, can help to optimize the course of skin disease. The modern domestic and foreign sources of literature were reviewed.
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Khanna, Raveena, Emily Boozalis, Micah Belzberg, John G. Zampella i Shawn G. Kwatra. "Mirtazapine for the Treatment of Chronic Pruritus". Medicines 6, nr 3 (6.07.2019): 73. http://dx.doi.org/10.3390/medicines6030073.
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Background: Chronic pruritus is a debilitating condition associated with a wide range of dermatologic, systemic and psychogenic etiologies. In patients with chronic pruritus that is refractory to conventional therapy, symptoms can significantly decrease quality of life by contributing to anxiety, sleep disturbances, and in many cases depression. Recent studies have demonstrated the effectiveness of mirtazapine in relieving chronic itch that is refractory to standard first-line therapies. Methods: We searched PubMed for English-language articles containing the words (“pruritus” or “itch”) AND “antidepressant” and then conducted a systematic review of the current literature to summarize the efficacy of mirtazapine in treating chronic itch. Results: All studies reported a reduction in itch intensity following the administration of mirtazapine. Conclusion: Collectively, these studies suggest the potential for mirtazapine to relieve chronic itch attributed to dermatological causes and malignancies. As, such mirtazapine may be an option for patients with chronic pruritus that is refractory to typical first-line treatments.
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Kishanrao, Suresh. "Senile Pruritis (SP) - An Emerging Geriatric Public Health Problem (EGPHP)!" Journal of Quality in Health Care & Economics 7, nr 3 (2024): 1–7. http://dx.doi.org/10.23880/jqhe-16000379.
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Background: Itching in any part of the body without a primary rash and in the absence of xerosis or other recognizable causes in a person over 65 years old is called Senile Pruritis. Though Pruritus is a relatively common symptom everybody experiences at any point in their life, it impacts quality of life among elderly population. Materials and Methods: This article is based on managing 2 cases and another rare case managed by the Dermatology department of a government medical college that was taken for medico-social case study for MPH scholars in the last 2 years. Relevant literature search on etiology and management practices across the globe complimented the article. Results: While the rare case taught the MPH scholars i) Idiopathic generalized pruritus is a diagnosis of exclusion, that is often difficult for primary health care providers to treat, ii) with Patients with uncontrolled idiopathic pruritus, failing to respond to standard treatment of topical applications, antihistamines and cortisone, Low-dose gabapentin can be tried. iii) An empathetic support from the family contributes to medical management. Two other cases are just a few days old, but responding to standard treatment well, need to be followed up for final long-term outcome. The standard approach consists of i) Oral antihistamines (containing Fexofenadine) ii) Chlorpromazine 25 mg at night for addressing Psychogenic component and iii) Topical application of Crotamiton 10% lotion on affected skin surface twice a day after bath.
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Biondi, M., T. Arcangeli i R. M. Petrucci. "Paroxetine in a Case of Psychogenic Pruritus and Neurotic Excoriations". Psychotherapy and Psychosomatics 69, nr 3 (2000): 165–66. http://dx.doi.org/10.1159/000012386.
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Misery, L., J. Wallengren, E. Weisshaar, A. Zalewska i F. Group. "Validation of Diagnosis Criteria of Functional Itch Disorder or Psychogenic Pruritus". Acta Dermato Venereologica 88, nr 5 (2008): 503–4. http://dx.doi.org/10.2340/00015555-0486.
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Roque Ferreira, Bárbara, i Laurent Misery. "Characteristics of Psychogenic Pruritus or Functional Itch Disorder: A Controlled Study". Acta Dermato-Venereologica 104 (1.11.2024): adv41352. http://dx.doi.org/10.2340/actadv.v104.41352.
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SANTOSA, I. KETUT ARYA, NI KETUT PUTRI ARIANI, DENNIS PRISCILLA SETIONO, RINI TRISNOWATI i I. KOMANG ANA MAHARDIKA. "PERSPEKTIF BIOPSIKOSPIRITUAL PADA PASIEN PRURITUS SINE MATERIA". HEALTHY : Jurnal Inovasi Riset Ilmu Kesehatan 3, nr 2 (7.11.2024): 122–26. http://dx.doi.org/10.51878/healthy.v3i2.3433.
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Pruritus Sine Materia is generalized pruritus without primary skin lession. It’s also catagorized as functional itch disorder or psychogenic pruritus. It is important to know the biopsychosociospiritual perspective as a psychiatrist in order to provide holistic therapy. Female, 40 years old, married, Moslem, lives in a boarding house, was consulted by a dermatovenerologist with Pruritus Sine Materia, complaints of itching without primary lesions since 3 months of marriage. She felt itchy in the local body area that is in contact with husband and his stuff. Skin test results are normal, without allergies. When she got married, she was surprised knowing that the husband's dog slept in the boarding room and on the mattress several times. There was saliva and dog urine on things in the room. The patient reminded his husband several times that they were Moslem, she hoped her husband would be aware of his behavior that was not according to religion. The patient is diagnosed with other somatoform disorder. She was prescribed antidepressant and benzodiazepine as pharmacological approach and got education, support, also behaviour therapies for her psychological capability to control the itch-scratch process. According to Islamic law, dogs are classified as extreme najis (mughallazhah), when they are exposed to sweat, saliva, feces and urine. Najis means ritually unclean, contact with it puts a Moslem in a state of impurity or disgust. The patient is faced with feelings of guilt because she does not carry out Islamic law properly. This causes negative religious coping related to the occurrence of anxiety and depression, which is a risk factor for psychogenic pruritus, Pruritus Sine Materia. It is important to understand the biopsychosociospiritual perspective to be able to determine the appropriate and holistic pharmacological and non-pharmacological treatment. ABSTRAKPruritus Sine Materia adalah pruritus generalisata tanpa lesi kulit primer. Ini juga dikategorikan sebagai gangguan gatal fungsional atau pruritus psikogenik. Pentingnya mengetahui pandangan biopsikosociospiritual sebagai seorang psikiater agar dapat memberikan terapi holistik. Sebuah studi kasus pada pasien wanita, 40 tahun, menikah, beragama Islam, tinggal di kos, berkonsultasi ke dokter kulit dengan Pruritus Sine Materia, keluhan gatal-gatal tanpa lesi primer sejak 3 bulan menikah. Dia merasa gatal di area tubuh yang bersentuhan dengan suami dan barang-barangnya. Hasil tes kulit normal, tanpa alergi. Saat menikah, ia terkejut mengetahui anjing milik suaminya beberapa kali tidur di kamar kos dan di kasur. Ada air liur dan urin anjing pada benda-benda di dalam ruangan. Pasien beberapa kali mengingatkan suaminya bahwa dirinya beragama Islam, ia berharap suaminya sadar akan perilakunya yang tidak sesuai agama. Pasien didiagnosis dengan gangguan somatoform lainnya. Dia diberi resep antidepresan dan benzodiazepin sebagai pendekatan farmakologis dan mendapatkan pendidikan, dukungan, serta terapi perilaku atas kemampuan psikologisnya dalam mengendalikan proses gatal-garuk. Menurut hukum Islam, anjing tergolong najis ekstrem (mughallazhah), jika terkena keringat, air liur, feses, dan urine. Najis berarti najis secara ritual, kontak dengan najis membuat seorang Muslim berada dalam keadaan najis atau jijik. Pasien dihadapkan pada perasaan bersalah karena tidak menjalankan syariat Islam dengan baik. Hal ini menyebabkan koping keagamaan yang negatif berhubungan dengan terjadinya kecemasan dan depresi yang merupakan faktor risiko terjadinya pruritus psikogenik, Pruritus Sine Materia. Penting untuk memahami perspektif biopsikosociospiritual untuk dapat menentukan pengobatan farmakologis dan nonfarmakologis yang tepat dan holistik.
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Misery, L., S. Alexandre, S. Dutray, M. Chastaing, SG Consoli, H. Audra, D. Bauer i in. "Functional Itch Disorder or Psychogenic Pruritus: Suggested Diagnosis Criteria From the French Psychodermatology Group". Acta Dermato-Venereologica 87, nr 4 (2007): 341–44. http://dx.doi.org/10.2340/00015555-0266.
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Foroutan, Nazanin, i Naemeh Nikvarz. "Role of Pregabalin in Management of Pruritus: A Literature Review". Journal of Pharmacy & Pharmaceutical Sciences 19, nr 4 (8.11.2016): 465. http://dx.doi.org/10.18433/j35k6n.
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Pruritus can be one of the distressing symptoms of many dermatologic, systemic, neurologic or psychiatric disorders. In each case, the origin of itch is in the skin and/or the nervous system. Involvement of the nervous system causes neurogenic, psychogenic or neuropathic itch. Itch sensation is transferred to the central nervous system via unmyelinated C-type nerve fibers, and many mediators and receptors engage in the its induction and transmission. Also it has been demonstrated that there are similarities and interactions between neurotransmitters and pathways of pain and itch sensation. Hence, effective drugs in reducing the neuropathic pain such as pregabalin have been studied and used in the management of different itchy conditions. In this narrative review we considered the available published papers dealing with the antipruritic effects of pregabalin. Results of studies conducted in uremic patients show that pregabalin is an effective option in reducing uremic pruritus especially in those who have not responded to antihistamines and topical moisturizers. Data about the effects of pregabalin on other itchy conditions are very limited; however results of the available studies show beneficial effects of this drug in burn patients with more than 5% involvement of the total body surface area, in prurigo nodularis, and in chronic and idiopathic itch. One considerable issue is that the therapeutic effects of pregabalin on uremic pruritus and post burn itch may appear more rapidly than its effects in the other conditions (1-2 weeks vs > 4 weeks). The most reported adverse effects of pregabalin are sedation, dizziness and drowsiness. Whether pregablin can be unequivocally considered as an effective and reasonable choice in the management of pruritus with different causes is a question that should be answered through large scale randomized controlled studies.
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Demirci, Onur Okan, Hülya Çeçen i Emrah Çinik. "Use of Mirtazapine Treatment in Erectile Dysfunction Associated with Psychogenic Pruritus: A Study of Two Cases". Journal of Clinical Psychiatry 19, nr 3 (2016): 145–48. http://dx.doi.org/10.5505/kpd.2016.69885.
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Mendonça, Felippe José Pontes de, Ivan Abdalla Teixeira i Valeska Marinho. "Ekbom Syndrome associated with Lewy Body Dementia: A case report". Dementia & Neuropsychologia 14, nr 1 (marzec 2020): 83–87. http://dx.doi.org/10.1590/1980-57642020dn14-010014.
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ABSTRACT Ekbom Syndrome, also known as parasitosis delusion or psychogenic parasitosis, is a rare condition in which patients present with a fixed belief of being infested by parasites, vermin or small insects, along with tactile hallucinations (such as pruritus or sensations of the parasites crawling over or under the skin). The syndrome may occur idiopathically or be associated with other medical conditions and drug use. This case report describes the occurrence of Ekbom syndrome in a patient diagnosed with Lewy Body Dementia (LBD), a neurodegenerative disease that commonly presents with sensory perception and thought disorders and other neuropsychiatric symptoms. Although visual hallucination is considered a core diagnostic criterion, other modalities of psychiatric symptoms can also occur posing a further challenge for correct diagnosis. Proper recognition allows early diagnosis and adequate treatment, preventing hazardous antipsychotic use in these patients.
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Brola, Waldemar, i Aleksandra Piąta. "The neurology of itch". Aktualności Neurologiczne 24, nr 2 (28.08.2024): 69–76. http://dx.doi.org/10.15557/an.2024.0011.
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Itch, or pruritus, is a common sensation, yet it is often treated lightly due to its usually transient nature. However, problems can arise once it becomes intense or prolonged, and treatment is ineffective. Itch generally affects diseased skin and accompanies systemic diseases; however, it can also be a reaction to allergens (mostly drugs) or have a psychogenic origin. Neurological itch is an itch that results from nervous system damage rather than issues with the skin. It affects non-diseased skin and arises as a result of dysfunction or damage to the neurons of the peripheral or the central nervous system. Its emergence can be influenced by metabolic, neurodegenerative, traumatic, infectious, autoimmune, and iatrogenic factors. Itch is accompanied by secondary symptoms including swelling, scrapes, excoriations or ulcerations, which result from the patient’s attempts to alleviate the symptoms. The diagnosis of itch is difficult and based on a detailed medical history and physical examination carried out in order to recognise the nature of the itch, which can also, in many cases, help find the most probable cause. There are no effective treatments for neurological itch. Management consists of a combination of patient education, physical therapy, psychotherapy, and attempts at a pharmacological treatment (antidepressants; antiepileptics − gabapentin and pregabalin; capsaicin; topical glucocorticosteroids).
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Сотникова, Ирина Валерьевна, i Игорь Борисович Сотников. "PSYCHOLOGICAL FEATURES OF PENAL OFFICERS WITH PSYCHOSOMATIC DISORDERS". Vestnik Samarskogo iuridicheskogo instituta, nr 2(43) (19.08.2021): 95–102. http://dx.doi.org/10.37523/sui.2021.23.77.01.
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В данной статье рассматриваются индивидуально-психологические особенности сотрудников уголовно-исполнительной системы, имеющих психосоматические заболевания (головную боль и кожные заболевания). Профессиональная деятельность сотрудников уголовно-исполнительной системы полна различных стрессогенных факторов: высокая степень ответственности, повышенный риск в деятельности, чрезмерное эмоциональное напряжение, что все вместе приводит к различным формам психической дезадаптации. Авторами систематизированы имеющиеся в психологии сведения по проблеме психогенной природы аффективных нарушений, лежащих в основе большинства психосоматических расстройств. Проведено эмпирическое исследование по выявлению индивидуально-психологических особенностей двух групп сотрудников уголовно-исполнительной системы с психосоматическими расстройствами (головная боль и кожные заболевания) и одной группы без психосоматических расстройств. Данное исследование позволило объективно осуществить сравнительный анализ индивидуально-психологических особенностей сотрудников уголовно-исполнительной системы . Применение психодиагностических методов дало возможность сказать о том, что у сотрудников уголовно-исполнительной системы, имеющих психосоматические расстройства (головная боль и кожные заболевания), отмечаются следующие психологические особенности: повышенная тревожность, низкая стрессоустойчивость, невротичность, эмоциональная лабильность, выражены признаки эмоционального выгорания. Результаты исследования дают возможность использования полученных данных в психологическом консультировании и сопровождении сотрудников уголовно-исполнительной системы, имеющих такие психосоматические расстройства, как головная боль и кожные заболевания (псориаз и кожный зуд). This article discusses the individual psychological characteristics of penal officers with psychosomatic diseases (for example, headache and skin diseases). The professional activity of penal officers is full of various stress factors: a high degree of responsibility, increased risk in activities, excessive emotional stress, all together leading to various forms of mental disadaptation. The author has systematized the information available in psychology on the problem of the psychogenic nature of affective disorders that underlie most psychosomatic disorders. An empirical study was carried out to identify the individual psychological characteristics of two groups of penal officers with psychosomatic disorders (headache and skin diseases) and one group without psychosomatic disorders. This study made it possible to objectively carry out a comparative analysis of the individual psychological characteristics of penal officers. The use of psychodiagnostic methods made it possible to say that penal officers with disorders (headache and skin diseases) have such psychological characteristics as: increased anxiety, low stress resistance, neuroticism, emotional lability, signs of emotional burnout are expressed. The results of the study make it possible to use the obtained data in psychological counseling and support of penal officers with psychosomatic disorders, headache and skin diseases (psoriasis and pruritus).
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Petruse, Liliana, Holger Kiesel i Silvana K. Rampini. "CME: Chronisch generalisierter Pruritus nicht-dermatologischer Ursache". Praxis 109, nr 14 (październik 2020): 1099–107. http://dx.doi.org/10.1024/1661-8157/a003595.
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Zusammenfassung. Chronisch generalisierter Pruritus ist ein häufiges Symptom. Dermatologische Ursachen müssen von nicht-dermatologischen Ursachen unterschieden werden. Nicht-dermatologisch bedingter Pruritus hat vielfältige Ursachen, wie systemische, infektiologische, neurologische, psychogene Erkrankungen und medikamentöse Nebenwirkungen, von denen einige mit einer signifikanten Morbidität verbunden sein können. Die Möglichkeit einer systemischen Erkrankung sollte bei Patientinnen und Patienten mit generalisiertem Pruritus und ohne Anzeichen für primäre Hautläsionen ausgeschlossen werden. Neben einer sorgfältigen Anamnese und körperlichen Untersuchung können ausgewählte Laboruntersuchungen hilfreich sein, um eine Diagnose zu stellen. Pruritus kann das erste Anzeichen einer malignen, im Besonderen hämatologischen, Erkrankung sein. Pruritus im Zusammenhang mit soliden Tumoren ist auch nicht so selten. Da chronischer Pruritus oft therapierefraktär ist, geht er mit einer deutlichen Einschränkung der Lebensqualität einher. Dieser CME-Artikel bietet eine Herangehensweise an den nicht-dermatologisch bedingten chronisch generalisierten Pruritus des Erwachsenen mit möglicher Abklärungsstrategie und differenzialdiagnostischen Überlegungen.
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Petruse, Liliana, Holger Kiesel i Silvana K. Rampini. "CME-Antworten: Chronisch generalisierter Pruritus nicht-dermatologischer Ursache". Praxis 109, nr 15 (listopad 2020): 1177–78. http://dx.doi.org/10.1024/1661-8157/a003596.
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Zusammenfassung. Chronisch generalisierter Pruritus ist ein häufiges Symptom. Dermatologische Ursachen müssen von nicht-dermatologischen Ursachen unterschieden werden. Nicht-dermatologisch bedingter Pruritus hat vielfältige Ursachen, wie systemische, infektiologische, neurologische, psychogene Erkrankungen und medikamentöse Nebenwirkungen, von denen einige mit einer signifikanten Morbidität verbunden sein können. Die Möglichkeit einer systemischen Erkrankung sollte bei Patientinnen und Patienten mit generalisiertem Pruritus und ohne Anzeichen für primäre Hautläsionen ausgeschlossen werden. Neben einer sorgfältigen Anamnese und körperlichen Untersuchung können ausgewählte Laboruntersuchungen hilfreich sein, um eine Diagnose zu stellen. Pruritus kann das erste Anzeichen einer malignen, im Besonderen hämatologischen, Erkrankung sein. Pruritus im Zusammenhang mit soliden Tumoren ist auch nicht so selten. Da chronischer Pruritus oft therapierefraktär ist, geht er mit einer deutlichen Einschränkung der Lebensqualität einher. Dieser CME Artikel bietet eine Herangehensweise an den nicht-dermatologisch bedingten, chronisch generalisierten Pruritus des Erwachsenen mit möglicher Abklärungsstrategie und differenzialdiagnostischen Überlegungen.
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Radmanesh, M., i S. Shafiei. "Underlying Psychopathologies of Psychogenic Pruritic Disorders". Dermatology and Psychosomatics / Dermatologie und Psychosomatik 2, nr 3 (2001): 130–33. http://dx.doi.org/10.1159/000049657.
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Nagata, M., K. Shibata, M. Irimajiri i A. U. Luescher. "Importance of psychogenic dermatoses in dogs with pruritic behavior". Veterinary Dermatology 13, nr 4 (sierpień 2002): 211–29. http://dx.doi.org/10.1046/j.1365-3164.2002.00298_31.x.
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Hamieh, Cima, Mahmoud El Hussein i Eric Revue. "Psychogenic pruritis as a cause of prurigo nodularis: a case report". Intercontinental Journal of Emergency Medicine 1, nr 3 (30.09.2023): 52–54. http://dx.doi.org/10.51271/icjem-0014.
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Prurigo Nodularis is a skin disease, secondary to a chronic scratching behavior. As multiple etiologies were said to be the cause of this condition, no clear pathophysiology has been described, and treatment is still not readily available. An elderly patient presented to the Emergency Department for confusion was found to have multiple excoriating lesions on the abdomen, back and extremities. Multiple treatment regimens were tried to manage this skin disease prior to this admission, with no improvements. This patient was eventually diagnosed with Prurigo Nodularis and treatment was initiated. In this case report we discussed the etiologies, presentation and management of Prurigo Nodularis, while focusing on the case in hand.
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Tlish, Marina M., i Polina S. Osmolovskaya. "Optimization of therapy in patients with lichen ruber planus by means of cranial electrotherapy stimulation". Almanac of Clinical Medicine 49, nr 8 (24.12.2021): 516–24. http://dx.doi.org/10.18786/2072-0505-2021-49-046.
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Rationale: Taking into account the significance of psychogenic factor in the onset of lichen planus, its correction is advisable. Transcranial electric stimulation is promising, given its autonomous regulating, analgesic, antipruritic, reparative and regenerative, and immunomodulatory effects, in addition to the anti-stress one.
Aim: To assess the effectiveness of the combination therapy including cranial electrotherapy stimulation (CES) with lichen ruber planus.
Materials and methods: This was an open label, prospective, comparative study in 61 patients with common typical form of lichen ruber planus (39 (63%) women and 22 (37%) men) aged 18 to 74 years (mean age 41 14.29 years). The duration of the disease was 11.88 10.15 months (range, 1 to 42 months). The patients were adaptively randomized into two groups of similar gender distribution, age, and disease duration. The patients in the comparison group (n = 30) were treated conventionally in accordance with the Federal Clinical Guidelines (chloroquine, hydroxyzine, topical corticosteroids). The main group (n = 31) was administered similar therapy; however, instead of hydroxyzine, CES was performed. The duration of in-patient treatment in both groups was 14 days, with the follow-up lasting for up to 3 months. The results of treatment were assessed by dynamics of pathological changes of the skin (Index of Lichen Planus, ILP), impact of dermatosis on various domains of the patients life (Dermatology Life Quality Index, DLQI), changes in psychological status (Hamilton Anxiety Scale and Hamilton Depression Scale). In addition, the impact of pruritus on the patients' daily activities was assessed by Behavioral Rating Scores questionnaire (BRS).
Results: At baseline, there were no significant differences between the groups in ILP (p = 0.801), DLQI (p = 0.501), BRS (p = 0.521), Hamilton Anxiety Scale (p = 0.301), and Hamilton Depression Scale (p = 0.493). At the end of treatment, ILP in the CES group decreased 3.25-fold (p 0.001), whereas in the group treated with conventional therapy the decrease was 2.1-fold (p 0.001); DLQI decreased 2.5-fold (p 0.001) and 1.8-fold (p 0.001), respectively. The corresponding decreases of Hamilton Anxiety Scale in the treatment groups were 2.3-fold and 1.3-fold, respectively, and those in Hamilton Depression Scale 2-fold and 1.6-fold, respectively (all p 0.001). In addition, statistically significant intergroup differences were found for ILP (p = 0.04), DQLI (p 0.001), Hamilton Anxiety and Depression scale scores (p = 0.021 and p = 0.006, respectively). As for the BRS changes, in both groups there was an equally significant (p 0.001) decrease, but the intergroup differences were not statistically significant (p = 0.485).
Conclusion: The proposed combination therapy of patients with lichen ruber planus including CES has led to a decrease in the indicators of the skin process activity within a shorter time period than in the patients under conventional treatment. In addition, the patients of both groups showed normalization of psychological parameters and improvement in dermatological quality of life; however, only in the CES group, these changes were significant.
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GIANNOULOPOULOS (Γ.Δ. ΓΙΑΝΝΟΥΛΟΠΟΥΛΟΣ), G. D., i M. N. SARIDOMICHELAKIS (Μ.Δ. ΣΑΡΙΔΟΜΙΧΕΛΑΚΗΣ). "To σύνδρομο της δερματίτιδας από λείξη των άκρων στο σκύλο". Journal of the Hellenic Veterinary Medical Society 63, nr 3 (15.12.2017): 227. http://dx.doi.org/10.12681/jhvms.15438.
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Canine acrai lick dermatitis is a complicated and challenging syndrome occurring in companion animal dermatology. Skin lesions are caused by intense and prolonged licking of a localized area, usually on the lower parts of the limbs that progressively may result in plaque or nodule formation with alopecia, erythema, hyperpigmentation, exudation,erosion and ulceration. Aerai lick dermatitis develops more often in male dogs of large breeds and has a multifactorial aetiology. The underlying causes may be broadly separated into organic (e.g., pruritic skin diseases, painful conditions) and psychogenic. The former subset includes mainly deep bacterial pyoderma, atopic dermatitis, food allergy, foreign bodies, sensory neuropathies and painful bone and articular diseases. The psychogenic subset may be either a primary (e.g., the result of long-standing anxiety, boredom, attention-seeking or stereotypic behavior) or a psychosomatic behavioural abnormality.Regardless of the aetiology and the primary role it may play, the most common complication in the psychogenic aerai lick dermatitis is actually the deep bacterial pyoderma observed in the majority of the cases. Diagnosis of the disorder is reached after exclusion of similar-looking skin diseases, such as ringworm kerion, demodicosis, leishmaniosis, sterile granulomas and neoplasia. An extensive list of diagnostic tests is necessary to identify the underlying cause(s) and includes cytological examination, bacterial culture and antibiotic susceptibility testing, histopathological examination, imaging of the affected area and hypoallergenic food trial. A prerequisite to diagnosing the psychogenic subset of the disease is to rule-out potential organic causes, coupled with persistence of skin licking, despite resolution of deep bacterial pyoderma.Regardless of the underlying cause, therapy should always include mechanical restrain, as well as the long-term topical and systemic use of antimicrobials that ideally should be selected based on the results of antimicrobial susceptibility testing. Specific treatment in also warranted to resolve potential organic causes of the syndrome, whereas, management of its psychogenic subset should be based on avoidance of the causative and triggering factors, desensitization and counter conditioning, along with the administration of psychotropic medication. Alternative therapeutic modalities, considered supplementary or employed when everything else fails, may include topical glucocorticoids, dimethyl sulfoxide, capsaicin or tacrolimus, as well as cryosurgery, laser surgery, acupuncture or radiation therapy.
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Powers, Jacquelyn M., Mark P. Shamoun, Timothy L. McCavit, Leah Adix i George R. Buchanan. "Efficacy and Safety of Intravenous Ferric Carboxymaltose in Children with Iron Deficiency Anemia Unresponsive to Oral Iron Therapy". Blood 126, nr 23 (3.12.2015): 4552. http://dx.doi.org/10.1182/blood.v126.23.4552.4552.
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Abstract Background The standard first line therapy for iron deficiency anemia (IDA) is oral iron. Yet, many patients fail to respond to oral iron due to poor adherence and/or adverse effects. Intravenous (IV) iron is an effective means of treating IDA in patients with malabsorption of iron or who are non-adherent and/or experience adverse effects with oral iron. Some IV iron preparations carry an FDA-mandated black box warning and/or require a test dose or prolonged infusion. Ferric carboxymaltose (FCM, Injectafer®) is a relatively new IV iron preparation with demonstrated safety and efficacy in adults with IDA. The manufacturer recommended dosing is 15 mg/kg/dose (maximum 750 mg) x2 doses administered at least 7 days apart, and each individual infusion can be administered over 10 to 15 minutes, without the need for a test dose. Limited data exist on its use in children. Our objective was to assess the hematologic response and adverse effects of IV FCM in a diverse population of infants, children and adolescents with IDA who failed oral iron therapy. Method All children with IDA who received FCM at Children's Health from June 1, 2014 through June 10, 2015 were included. Subjects were identified via search of pharmacy records. All patients received at least one dose of FCM 15 mg/kg (maximum 750 mg) administered as a 15-minute IV infusion (without test dose or pre-medications). Patient characteristics, adverse effects and hematologic response were retrospectively collected from the electronic medical record. Results During the study frame, one hundred twenty-five infusions of FCM were administered to 87 patients (71% female) with a median age of 14 years (range 9 months to 20.8 years). The most common racial/ethnic group was Caucasian/White (Latino) at 45% followed by African American/Black and Caucasian/White (Non-Latino), each at 22%. The primary etiologies were heavy menstrual bleeding (38%), nutritional (24%), and GI bleeding and/or malabsorption (20%) with the remaining 18% representing other/mixed causes of IDA (e.g., inflammatory). The median dose administered during a single infusion was 750 mg (range 132 to 750 mg). No adverse effects were noted during or following the infusion in 77 subjects. Two patients had transient tingling, nausea and/or mild abdominal pain. Five others developed generalized pruritis and/or urticaria and received diphenhydramine and/or hydrocortisone, with prompt resolution. Two adolescents had more clinically significant reactions, 1 with nausea/vomiting post-infusion (likely psychogenic) requiring admission, and 1 with dyspnea 2 minutes into the infusion, requiring its immediate termination and administration of diphenhydramine, hydrocortisone and normal saline with prompt symptom resolution. One patient experienced asymptomatic extravasation during the second infusion which resulted in localized iron-staining of the skin. Median pre-infusion hemoglobin concentration for all patients was 9.1 g/dL (range 3.9 to 13.3 g/dL) (Table). A follow-up measurement was available for 76 patients at a median time of 6 weeks (range 1 to 30 weeks) post-initial infusion with a median hemoglobin increase of 3.3 g/dL (range -1.5 to 9.5 g/dL). Conclusion Intravenous FCM, administered in an outpatient infusion setting as one or two short IV infusions and without need for a test dose, was safe and effective in most children and adolescents with IDA refractory to oral iron therapy. Further clinical data are necessary to more fully characterize the extent of adverse effects in young patients. Prospective studies of IV FCM in children are indicated to assess clinical efficacy, including outcomes such as health related quality of life and fatigue. Table. *Hematologic Response to FCM Pre-Infusion **Post-Infusion Hemoglobin concentration (g/dL) All Etiologies, Pre (n=87), Post (n=76) Heavy menstrual bleeding, Pre (n=33), Post (n=26) Nutritional, Pre (n=21), Post (n=20) - 9.1 (3.9 to 13.3) 9.3 (4.2 to 13.3) 8.8 (4.9 to 12.2) - 12.2 (7.1 to 16) 12.7 (8.8 to 16) 12.2 (10.5 to 13.7) Mean corpuscular volume (fl), Pre (n=87), Post (n=76) 71.6 (49.5 to 97.4) 80.9 (53.3 to 102) Serum ferritin (ng/mL), Pre (n=80), Post (n=60) 5.2 (0.6 to 288.6) 115.7 (2.3 to 679.3) *Median laboratory values are reported. **Follow-up laboratory testing occurred at median time of 6 weeks (range 1 to 30 weeks) post-infusion. Disclosures Powers: Gensavis Pharmaceuticals, LLC: Research Funding. McCavit:Pfizer: Research Funding; Gensavis LLC: Research Funding; Novartis: Speakers Bureau. Adix:Gensavis Pharmaceuticals, LLC: Research Funding. Buchanan:Gensavis Pharmaceuticals, LLC: Research Funding.
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Hashimoto, Takashi, i Satoshi Okuno. "Practical guide for the diagnosis and treatment of localized and generalized cutaneous pruritus (chronic itch with no underlying pruritic dermatosis)". Journal of Dermatology, 12.12.2024. https://doi.org/10.1111/1346-8138.17565.
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AbstractItch, also known as pruritus, is one of the most prevalent symptoms observed in dermatological practices. Itch frequently arises from primary pruritic dermatoses, although it may also manifest in the absence of a primary pruritic skin rash. The latter itchy condition is referred to as “cutaneous pruritus” in the Japanese guidelines published in 2020. Cutaneous pruritus can be classified into two categories based on its distribution: localized cutaneous pruritus and generalized cutaneous pruritus. Localized cutaneous pruritus is indicative of a neuropathic cause, whereas generalized cutaneous pruritus suggests underlying systemic disease(s), drug‐induced itch, psychogenic itch (also known as functional itch disorder), or chronic pruritus of unknown origin (CPUO). Systemic diseases associated with cutaneous pruritus include disorders of iron metabolism, chronic kidney disease, chronic liver disease (especially cholestasis), endocrine/metabolic diseases, hematological disorders, and malignant solid tumors. CPUO is a term used to describe chronic itch that is often generalized and for which no underlying cause can be identified despite a comprehensive and careful diagnostic workup. A variety of treatment approaches are available for cutaneous pruritus, including device‐based physical therapies (such as phototherapy) and medications that act on the itch‐perception processing pathway from the skin, peripheral sensory nerves, the spinal cord, to the brain. This review presents an overview of the current knowledge regarding cutaneous pruritus, from its underlying pathophysiologic mechanisms to the diagnostic procedures and treatment approaches that are currently available.
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Ghani, Hira, Sasha Ghofrani i Mohammad Jafferany. "Therapeutic challenges and novel treatment options in psychogenic pruritus". Archives of Dermatological Research 317, nr 1 (14.12.2024). https://doi.org/10.1007/s00403-024-03644-3.
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Misery, Laurent. "Pruriplastic Itch—A Novel Pathogenic Concept in Chronic Pruritus". Frontiers in Medicine 7 (20.01.2021). http://dx.doi.org/10.3389/fmed.2020.615118.
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The International Association for the Study of Pain (IASP) defined three descriptors for pain: nociceptive pain is “pain that arises from actual or threatened damage to non neural tissue and is due to the activation of nociceptors”; neuropathic pain is “pain caused by a lesion or disease of the somatosensory nervous system”; and nociplastic pain is “pain that arises from altered nociception despite no clear evidence of actual or threatened tissue damage causing the activation of peripheral nociceptors or evidence for disease or lesion of the somatosensory system causing the pain.” Based on clinical and pathophysiological arguments, a similar definition of “pruriplastic pruritus” should be made. Pruriplastic pruritus would include psychogenic pruritus, as well as some cases of pruritus ani, vulvar pruritus, sensitive skin or other poorly understood cases of pruritus. This new descriptor of itch could serve as systematic screening for altered pruriceptive function in patients who suffer from chronic itch and it may also help in defining better tailored treatment by identifying patients who are likely to respond better to centrally rather than to peripherally targeted therapies.
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Emmanuel, Ozzy M., Ana V. Karovska i Okey Ikedilo. "Scabies-induced lichen simplex chronicus misdiagnosed as psychogenic pruritus: a case report". Journal of Medical Case Reports 15, nr 1 (17.02.2021). http://dx.doi.org/10.1186/s13256-020-02628-x.
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Abstract Introduction Lichen simplex chronicus has been defined as a localized skin condition characterized by thickening, hyperpigmentation and accentuated skin markings from chronic itching and from repeated scratching. The affected skin area is usually described as demarcated, and often circumscribed. It has even been defined as a “psychogenic pruritic disorder”. The idea of a neurological component has also been suggested, hence the term 'neurodermatitis circumscripta'. However, the pathophysiology of this condition remains unclear. Several associations and etiologies have been reported in literature, including strong links with mental disorders—anxiety and obsessive compulsive disorder to be specific. We report this case, most importantly, to highlight the value of an open-minded approach to patients and the 'old-fashioned' physician character of empathy, the skill of detailed history taking and physical examination, and lastly to suggest that lichen simplex chronicus may not always present as a localized, 'circumscripta' or demarcated area of skin. Case description When a sixty-five year-old Caucasian female presented to our clinic agitated, intensely scratching her entire body and complaining of severe pruritus, an open-minded detailed approach during history taking and physical examination led to the working diagnosis of diffuse lichenification from chronic scratching secondary to a “possible” cutaneous disorder. Her medical history was unremarkable, but her psychiatric history was significant for Anxiety disorder. She remained on her anxiolytic medication. Her presenting symptom was reported to have persisted for more than 9 months. Review of previous unremarkable lab results and a remarkable findings on detailed skin inspection led to an empiric, trial regimen consisting of three topical preparations: an anti-pruritic—to break the itch-scratch cycle, anti-inflammatory—to curb any inflammatory/immune response and a 'last-ditch' scabicidal application. Follow-up was scheduled, but the patient called the office requesting an earlier follow up appointment. The lesions had significantly improved and the hyper-pigmented, indurated and escoriated skin appearance had resolved; and most importantly, the pruritus. Conclusion Thus we conclude that lichen simplex chronicus may not always present as circumscribed or localized area of skin as currently noted in literature. Also, in patients with psychiatric conditions including anxiety and obsessive-compulsive disorder in particular, effort should be made to avoid stereotyping their presentation as part of their mental disorder spectrum. The value of detailed history and physical examination, mixed with empathy is highlighted. We make our recommendation considering the profound turnaround in the patient's condition and quality of life after several months of emotional and psychological suffering.
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Dr. Amit Beniwal, Dr. Aman Singh, Dr. Debalina Biswas, Dr. Tabish Brar, Dr. Vivek Pathak, Dr. Brijesh Saran i Dr. A. K. Seth. "Psychogenic pruritus: rapid response with a combination of selective serotonin reuptake inhibitors and benzodiazepine". Journal of Pharmaceutical Negative Results, 12.10.2022, 553–54. http://dx.doi.org/10.47750/pnr.2022.13.s06.076.
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A 45-year-old woman presented to us with generalized pruritus for the last 6 years. The itch was moderate in intensity causing interference with her daily activities and sleep. The pruritus was maximum in the evenings and there was no seasonal variation. It was not associated with any skin lesion. She did not have associated complaints of pain or altered sensation over the affected sites. She was a known case of diabetes mellitus and hypertension for the last 6- years which were moderately controlled with her medications. There was no history of atopy and any other systemic illnesses such as hypothyroidism or chronic liver and kidney diseases. There was a history of significant family stressors before the initiation of these episodes and aggravation of itch was noted with various stressors. The itch did not improve with her medications taken over the years such as antihistamines, antifungals, and antibiotics. Recently, she also started noticing palpitation and sweating associated with these episodes. The intensity of pruritus based on visual analogue scale was 7.
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Ferreira, Bárbara Roque, i Laurent Misery. "Alexithymia and dissociation in psychogenic pruritus: Clinical relevance and therapeutic implications". Journal of the European Academy of Dermatology and Venereology, 4.03.2024. http://dx.doi.org/10.1111/jdv.19918.
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Aytulun, Asli, Elcin Eroglu, Mevhibe Yildiz, Basak Armagan i Mumin Yazici. "ORAL NALTREXONE IN THE TREATMENT OF CHRONIC PSYCHOGENIC PRURITUS: A CASE REPORT". Psychiatry and Clinical Psychopharmacology, 2020, 1. http://dx.doi.org/10.5455/pcp.20200401103430.
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Orliaguet, Marie, Emilie Brenaut, Anne‐Sophie Ficheux, Sylvie Boisramé i Laurent Misery. "Psychogenic and neurogenic components in patients with psychogenic or neuropathic pruritus: PRURINEURO: A non‐interventional single‐centre prospective assay". Skin Health and Disease, 19.07.2023. http://dx.doi.org/10.1002/ski2.267.
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Kazgan Kilicaslan, Asli, Sevler Yildiz, Osman Kurt i Murad Atmaca. "Personality Characteristics, Anxiety Sensitivity, Anxiety, and Depression Levels on Patients Diagnosed with Psychogenic Pruritus". ALPHA PSYCHIATRY, 5.08.2022. http://dx.doi.org/10.5152/alphapsychiatry.2022.21699.
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Ait Oussous, Sara, Mohammad Jafferany i Radia Chakiri. "Psychodermatology knowledge, awareness, and practice patterns among Moroccan dermatologists: a national survey study". Clinical and Experimental Dermatology, 13.06.2023. http://dx.doi.org/10.1093/ced/llad204.
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Abstract We aimed to assess the knowledge, attitudes, and practices patterns of Moroccan dermatologists and their awareness of psychodermatology (PD). A survey questionnaire was distributed to dermatologists and dermatology trainees from May to July 2022. A total of 112 completed surveys were received. 63.4% were dermatologists and 36,6 % were dermatology residents. 72.3% summarized psychodermatology as the psychological impact of dermatological conditions. 50.9% reported frequent involvement with PD. Patients with a psycho-cutaneous condition represented a significant proportion of dermatological consultations (10 to 25% in 41.1%). Only 17% felt “very comfortable” in the management and 56.3% were not confident prescribing psychotropics. Trichotillomania (83%), psychogenic pruritus (67%) and delusions of parasitic infestation (67%) were the main disorders for referral. 88.4% had never participated in PD training. Moroccan dermatologists lack a full understanding and proper training in psychodermatology. We recommend the incorporation of psychodermatology curriculum in training programs and advocate dermatology and psychiatry liaison.
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BAKIR, Alanur, i Hüseyin VOYVODA. "Successful Treatment with Dexamethasone of a Cat with Suspected Feline Atopic Skin Syndrome Not Responding to Prednisolone". Animal Health Production and Hygiene, 11.09.2023. http://dx.doi.org/10.53913/aduveterinary.1289183.
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A 6-year-old client-owned indoor, female neutered Persian-exotic shorthair cat was presented for further investigation of severe itchy lesions on the head and neck to our polyclinic. The patient had previously been applied selamectin and a cleansing, soothing, and protecting shampoo, but did not respond positively to the treatment. After the exclusion of ectoparasite infestation, retroviral infection, neoplastic and psychogenic causes, and food allergy, a suspect diagnosis of FASS in the cat was made. Although skin lesions clearly improved, the intensity of pruritus did not reduce during the 4-week prednisolone therapy. Based on these results, the case was considered to be resistant to prednisolone. Treatment with dexamethasone provided a fast and complete recovery of clinical signs and the cat has been clinically healthy maintained for over 2-years. This study suggests that oral dexamethasone can be a good alternative for treating cats with suspected FASS that has not responded positively to prednisolone therapy.