Infectious differential diagnosis of chronic generalized pruritus without primary cutaneous lesions: a review of the literature

Abstract

Pruritus is one of the most common complaints among patients referred to a dermatology clinic. “Chronic generalized pruritus” is described as the sensation of itching on the entire body surface, which lasts at least 6 or more weeks. This symptom can be a disabling phenomenon for patients and may sometimes interfere with daily activities such as sleep. If specific dermatological findings are observed, the physician easily comes to a diagnosis and treats the condition, whereas, when primary lesions are not detected, the diagnosis can become challenging, and some patients have to undergo extensive evaluations. The association between some systemic disorders and chronic generalized pruritus is widely known and confirmed. Many infections have been associated with pruritus, but few are considered to cause chronic generalized pruritus without any characteristic skin lesions. We aimed to gather all the available data on infectious causes of chronic generalized pruritus with no diagnostic cutaneous lesions to assist fellow physicians in the process of evaluation of these challenging cases.

Chronic Pruritus in the Absence of Skin Disease: A Retrospective Study of 197 French Inpatients

“…The search for toxocariasis was sometimes realized, but its place in the assessment of pruritus assessment remains to be confirmed. CP may be a cutaneous manifestation of toxocariasis, but no significant relationship has been found ( 5 , 7 , 24 ). Among the serologies performed, 23.2% were positive, and the treatment of toxocariasis was never accompanied by complete regression of the pruritus.…”