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neurogenic pruritus
Etiology:
- cholestatis
- end-stage renal disease
- hypothyroidism
- hyperthyroidism
- iron-deficiency
- malignancy (hematopoietic, lymphoma, Hodgkin's disease)
- medications (opiates)
- HIV
- idiopathic
Clinical manifestations:
- absence of visible skin lesions or the presence of only secondary skin lesions (exoriations, lichenification) in areas easily scratched with sparing or regions that the patient cannot reach
Laboratory:
1) complete blood count (CBC) with differential
2) thyroid function tests
3) serum iron, TIBC, serum ferritin
4) liver function tests
a) serum AST, serum ALT
b) serum alkaline phosphatase
c) serum bilirubin
d) serum GGT
e) bile acids in serum
5) renal function tests
a) serum creatinine
b) serum urea nitrogen
6) serum protein electrophoresis if indicated
Radiology:
- chest X-ray for possible Hodgkin's disease
Differential diagnosis:
- neuropathic pruritus
Management:
- see pruritus or specific etiology
Related
neuropathic pruritus
General
pruritus (itching)
References
- Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 18.
American College of Physicians, Philadelphia 2009, 2012, 2018.