Nonsedating

12-Oct-2019 00:40

A detailed history is important in chronic pruritus of unknown origin, including general health (fever, chills, weight loss); skin (pigmentation, sweating, asteatosis, plethora, and jaundice); hair (growth, texture, loss); nails (Beau's lines, onycholysis, color changes); eyes (exophthalmos, color changes); and endocrine, hematopoietic, gastrointestinal, genitourinary, neurologic, and mental status.The skin should be examined for evidence of any recognizable disorder.Excessive bathing and contact allergy to topical therapies can lead to dermatitis.These findings should not be interpreted as the primary skin disorder.

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Examination of the upper midback can help in this distinction, because it is relatively inaccessible and unavailable for scratching.

Back to Top Itch can be produced by mechanical (gentle touch, pressure, vibration, and wool), thermal and electrical stimuli such as transcutaneous or direct nerve stimulation.

The sensation is received by free nerve endings in the skin and transmitted via unmyelinated C fibers and myelinated Aδ fibers to the central spinothalamic tracts.

Look for evidence of parasitic infestation, especially scabies and lice.

Examination of the skin, hair, and genitalia with surveillance scrapings can identify either disorder.

Examination of the upper midback can help in this distinction, because it is relatively inaccessible and unavailable for scratching.

Back to Top Itch can be produced by mechanical (gentle touch, pressure, vibration, and wool), thermal and electrical stimuli such as transcutaneous or direct nerve stimulation.

The sensation is received by free nerve endings in the skin and transmitted via unmyelinated C fibers and myelinated Aδ fibers to the central spinothalamic tracts.

Look for evidence of parasitic infestation, especially scabies and lice.

Examination of the skin, hair, and genitalia with surveillance scrapings can identify either disorder.

Opioids have a central pruritic action and also act peripherally by augmenting histamine itch.