Pruritus is a symptom that can occur with many different conditions. Respiratory System (J00-J99).
- Allergic rhinitis (hay fever).
Blood, blood-forming organs – immune system (D50-D90).
Endocrine, nutritional, and metabolic diseases (E00-E90).
- Iron deficiency
- Diabetes insipidus – hormone deficiency-related disorder in hydrogen metabolism, resulting in extremely high urine excretion (polyuria; 5-25 l/day) due to impaired concentration capacity of the kidneys.
- Diabetes mellitus type 2
- Hemochromatosis (iron storage disease)
- Hyperparathyroidism – excessive production and secretion of parathyroid hormone, triggered by an adenoma or hyperplasia of one or more parathyroid glands (epithelial corpuscles); this leads to increased bone resorption and thus to an increased calcium concentration in the blood
- Malnutrition
- Thyroid dysfunction (hypo- or hyperthyroidism / hypothyroidism or hyperthyroidism).
Skin and subcutaneous (L00-L99).
- Allergic contact dermatitis (contact allergy) – skin inflammation resulting from an allergic reaction.
- Drug exanthema
- Atopic eczema (neurodermatitis)
- Dermatitis herpetiformis (synonyms: Duhring’s disease, Duhring-Brocq disease) – skin disease from the group of blistering autoimmune dermatoses with subepidermal blistering.
- Herpes gestationes (pemphigoid gestationes) – skin disease in pregnancy.
- Lichen sclerosus – rare, chronic inflammatory, progressive connective tissue disease of the skin.
- Bullous pemphigoid – most common autoimmune disease of old age.
- Eczema – contact eczema, the exsiccation eczema (also called eczema of old age, or eczéma craquelé).
- Lichen ruber planus (nodular lichen).
- Lichen sclerosus et atrophicans (genital)
- Lichen simplex
- Miliaria rubra (synonyms: Dermatitis hidrotica, Friesel, Hidroa, heat pimples, heat flares, sweat frizzles, sweat vesicles, sweat blisters, red dog) – usually itchy rash (Miliaria rubra = itchy reddish papules, vesicles or papulovesicles) caused by increased sweating in hot weather.
- Paraneoplastic pruritus, due toe.g. lymphoma, esp. Hodgkin’s disease, polycythaemia vera; symptoms: generalized itching, possibly aquagen (“water-related”; aquagenic pruritus) or with alcohol consumption.
- Pityriasis rosea (rose lichen).
- Prurigo simplex acuta – disease with episodic, disseminated, itchy papules; mainly children affected.
- Pruritus sine materia: pruritus without apparent cause.
- Psoriasis (rare; especially in psoriasis inversa or psoriasis guttata).
- Stasis dermatitis (eczema venosum) – therapy-resistant chronic dermatitis (inflammatory reaction of the skin) of the lower legs in chronic venous insufficiency (CVI; chronic venous insufficiency); is accompanied by the clinical symptom triad redness, scaling and excoriations (areal substance defect of the skin); the type of eczema varies from neurodermatitis-like areal affection to the nummular (coin-shaped skin change)-microbial type; in the nummular-microbial type, the hyperpigmented eczema foci are not infrequently located above the visible varices (varicose veins)
- Urticaria (hives)
- Xeroderma (dry skin)
Cardiovascular system (I00-I99)
- Apoplexy (stroke)
Infectious and parasitic diseases (A00-B99).
- Bacterial infections, unspecified
- Exanthematic viral diseases (e.g., chickenpox).
- Hepatitis C (inflammation of the liver of the virus type C).
- Herpes zoster (shingles)
- HIV infection (due todry skin)
- Mycoses (fungal diseases)
- Parasitoses (parasite infestation)
- Scabies (scabies)
Liver, gallbladder and bile ducts – Pancreas (pancreas) (K70-K77; K80-K87).
- Cholestasis (biliary stasis) – cholestatic pruritus; in liver disease (e.g., primary biliary cholangitis/bile duct inflammation (PBC, synonyms: nonpurulent destructive cholangitis; formerly primary biliary cirrhosis), hepatitis B-/-C infection) – hepatic pruritus:
- Circadian rhythm, strongest intensity in the evening and at night; localization on the extremities, esp. on palms and soles; pruritus may also be generalized
- Women: Increase in pruritus premenstrually, by hormone replacement therapy (HRT) and at the end of pregnancy.
Mouth, esophagus (esophagus), stomach, and intestines (K00-K67; K90-K93).
- Digestive disorders, unspecified
Musculoskeletal system and connective tissue (M00-M99).
- Gout (hyperuricemia) – deposition of uric acid in the skin.
Neoplasms – tumor diseases (C00-D48) [pruritus may precede diagnosis by years].
- Brain tumors – pruritus of the nostrils.
- Carcinoid tumor (synonyms: Carcinoid syndrome, neuroendocrine tumors, NET) – tumors originating from the neuroendocrine system; they are predominantly located in the appendix/appendix (appendiceal carcinoid) or bronchus (bronchus carcinoid); other localizations include the thymus (thymic carcinoid), ileum/ruminal intestine (ileal carcinoid), rectum/foregut (rectal carcinoid), duodenum/duodenal intestine (duodenal carcinoid), and stomach (gastric carcinoid); typical symptoms are characterized by the triad of diarrhea (diarrhea), flushing (facial flushing), and Hedinger syndrome (endocardial fibrosis of the right heart, which can lead to tricuspid regurgitation (leakage with backflow of blood from the heart valve between the right atrium and the right ventricle) and pulmonary stenosis (narrowing in the outflow tract from the right ventricle to the pulmonary artery).
- Cutaneous D-cell lymphoma (erythrodermic mycosis fungoides, Sézary syndrome).
- Leukemias (blood cancers) – e.g. chronic myeloid leukemia (CML), chronic lymphocytic leukemia (CLL).
- Lymphomas (tumors of the lymphatic system) – Hodgkin’s disease, non-Hodgkin’s lymphoma.
- Mastocytosis – two main forms: cutaneous mastocytosis (skin mastocytosis) and systemic mastocytosis (whole body mastocytosis); clinical picture of cutaneous mastocytosis: Yellowish-brown spots of varying size (urticaria pigmentosa); in systemic mastocytosis, there are also episodic gastrointestinal complaints (gastrointestinal complaints), (nausea (nausea), burning abdominal pain and diarrhea (diarrhea)), ulcer disease, and gastrointestinal bleeding (gastrointestinal bleeding) and malabsorption (disorder of food absorption); in systemic mastocytosis, there is an accumulation of mast cells (cell type involved, among other things, in allergic reactions). Among other things, involved in allergic reactions) in the bone marrow, where they are formed, as well as accumulation in the skin, bones, liver, spleen and gastrointestinal tract (GIT; gastrointestinal tract); mastocytosis is not curable; course usually benign (benign) and life expectancy normal; extremely rare degeneration mast cells (= mast cell leukemia (blood cancer)).
- Paraneoplastic syndrome – non-metastatic, based on humoral remote effect abdominal tumor disease symptoms that may subside after tumor removal.
- Polycythaemia vera – pathological multiplication of blood cells (particularly affected are: especially erythrocytes / red blood cells, to a lesser extent also platelets (blood platelets) and leukocytes / white blood cells); prickly itching after contact with water (aquagenic pruritus) or with temperature fluctuations.
Psyche – nervous system (F00-F99; G00-G99).
- Anorexia nervosa (anorexia nervosa)
- Depression
- Dermatozoa delusion – delusional belief that living things are under the skin.
- Multiple sclerosis (MS)
- Polyneuropathy – disease of the nerves of the peripheral nervous system; depending on the cause, motor, sensory or autonomic nerves may be affected; sensitivity disorders.
- Postzosterneuralgie (PZN) – extremely severe nerve pain (neuralgia) as a result of shingles (herpes zoster).
- Tabes dorsalis (Neurolues) – late stage of syphilis, in which there is demyelination of the spinal cord.
Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).
- Icterus (jaundice)
- Pseudoallergies (e.g., due toexcipients in drugs).
Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).
- Kraurosis vulvae (vulvar dystrophy) – Pruritus vulvae (itching of the external female genital organs).
- Renal insufficiency (kidney failure), chronic – renal (kidney-related) pruritus.
- Uremia/dialysis patients (occurrence of urinary substances in the blood above normal values; urinary intoxication) – uremic pruritus (synonym: nephrogenic pruritus); often generalized; felt most strongly on the legs (20-50% of these patients).
Injuries, poisonings, and certain other sequelae of external causes (S00-T98).
- Insect bites
- Food allergy
- Pseudoallergy (eg due toexcipients in medicines).
Medication
- See “Causes” under medications
Environmental pollution – intoxications (poisonings).
- Irritants (chemicals, solvents)
- Air conditioning (dry air)
- Overheated rooms
- Dry room climate
- Sun (frequent sunbathing)
- Winter (cold) → reduction of sebaceous gland secretion.
Further
- Gravidity (pregnancy)
- Climacteric (menopause)
- Senium (old age)
