Chronic generalized pruritus without primary skin lesions: a longitudinal prospective observational study

Abstract

Pruritus is among the most common complaints in the field of dermatology. It is also a disturbing symptom of many systemic disorders. Chronic pruritus (CP) refers to the cases of the symptom which last longer than 6 weeks. We conducted a prospective analysis of patients with generalized pruritus without primary skin lesions. All patients underwent primary evaluations and then were followed from 12 to 18 months for further evaluations. Of the 5,127 patients referred to our dermatology clinic, 49 patients with generalized pruritus without primary skin lesions were evaluated. Most of the patients (44%) were in the age group of 40-60 years and female (58%). The duration of pruritus was 37.04 ± 30.4 weeks. Fifty percent of the patients with generalized pruritus had a systemic cause of pruritus. The most common underlying diseases were thyroid disorders (16.67%), diabetes mellitus (12.5%), and malignancy (8.33%). There were no significant statistical differences among the patients in terms of their age, gender, and disease duration with the underlying diseases (P = 0.47, P = 0.99, P = 0.816, respectively). However, the average age of the onset of pruritus was 12 years earlier in the women regardless of the underlying diseases (P = 0.011). Based on the findings of the study, we recommend considering endocrine disorders and malignancies as the most common underlying diseases leading to chronic pruritus without primary skin lesions.

Itch in diabetes: a common underestimated problem

“…In a study comprising 350 individuals, by Ahmed et al [33], itch was reported in 7.1%. Another perspective was chosen by Alizadeh et al [13] who examined 5 127 patients referred to the dermatologic clinic with chronic generalized itch without primary skin lesions -12.5% of them had DM.…”

“…According to the International Forum for the Study of Itch (IFSI), the etiologic classification of chronic itch comprises 6 categories: (I) dermatologic, (II) systemic, (III) neurologic, (IV) psychogenic/psychosomatic, (V) mixed, and (VI) others [12]. Most researchers classify itch in diabetes as systemic itch [13], however some authors suggest mixed aetiology of diabetic itch with the additional involvement of both dermatologic and neurologic components [14][15][16]. Diabetes mellitus appears in most lists of the causes of generalized itch but is not common.…”

Itch in Adult Population with Type 2 Diabetes Mellitus: Clinical Profile, Pathogenesis and Disease-Related Burden in a Cross-Sectional Study

“…According to the International Forum for the Study of Itch (IFSI), we may divide the etiologic classification of chronic itch to 6 categories: (I) dermatologic, (II) systemic, (III) neurologic, (IV) psychogenic/psychosomatic, (V) mixed, and (VI) others [ 4 ]. IFSI classifies itch in diabetes as systemic itch arising on non-inflamed skin or normal-appearing skin [ 5 ]. However, researchers have recently suggested that the etiology of itch in DM is additionally involved with both dermatologic and neurologic components [ 6 , 7 , 8 ].…”

Itch in Children with Type 1 Diabetes: A Cross-Sectional Study

“…It is a frequent and distressing symptom occurring not only in dermatologic conditions but also in chronic systemic diseases [ 5 , 6 ], posing a high burden and decrease in quality of life (QoL) of patients [ 7 , 8 ]. Most researchers classify itch in diabetes, according to the International Forum for the Study of Itch (IFSI), as systemic itch [ 9 ]; however, some authors suggested mixed etiology of diabetic itch with the additional involvement of both dermatologic and neurologic components [ 10 – 12 ]. Only a few studies investigated the occurrence of itch in DM, reporting a wide prevalence ranging from 18.4–27.5% [ 13 ].…”