Evaluation of Pruritus in 100 Patients

Introduction: Pruritus is a subjective symptom of multifactorial nature, its assessment may be challenging. Generalized pruritus can often be a manifestation of underlying systemic disease. So, patients with generalised itch must be thoroughly investigated. Materials and Methods: Patients with pruritus who attended dermatology department were evaluated for associated systemic causes. Both males and females of all age groups were included. Patients having itching with primary skin lesions were excluded. Detailed history, complete clinical examination, hemogram including peripheral smear, liver function tests(LFT) and renal function tests, viral markers (HIV, HBsAg and HCV) and complete urine analysis were done in all cases. Endoscopy, Ultrasound, Computer tomography and Magnetic resonance imaging were done in necessary cases. Results: Of the 100 cases, 69 were males and 31 females. Associated cause was found in 62%, Diabetes Mellitus (15), Hypothyroidism (12), Chronic renal failure (8), HIV disease (7), Viral hepatitis (6), Iron deficiency anemia(4), Hepatocellular carcinoma (2), Hyperthyroidism (2), Non-Hodgkin’s lymphoma (2), Cholangiocarcinoma (1), Cholecystitis (1), Pancreatic carcinoma (1), and Polycythemia Vera (1). Despite all the above investigations, no cause could be found in the rest of 38% of pruritus patients. Conclusion: Pruritus is not uncommon presentation. Proper evaluation can lead to finding a systemic cause in majority of cases and will help in the management. Keywords: Pruritus, Malignancy, Diabetes mellitus, HIV, Hepatitis, Iron deficiency.