Internal causes of pruritus

Pruritus can have a variety of internal causes like celiac diasease,liver or kidney disease and iron deficiency anaemia can also cause itching type of symptoms. People with celiac disease where they are unable to tolerate gluten often associated with a skin condition called dermatitis herpetiformis.it is caused by immune reaction triggered by gluten. Although fatigue is the common symptoms of anemia some of the patient may have generalised itching and brittle nails which indicates the iron deficiency anemia

Introduction and Symptoms

Pruritus is the medical term for itchy skin, and can affect small parts of the body or the entire body. The main symptom of this common skin problem is the urge to keep scratching the affected area. Other symptoms may include rashes on skin, redness, cracked skin, bumps, or blisters.

Risk factors or causes

There are a number of factors that can cause skin to become itchy. They include dry skin, skin conditions such as scabies, eczema and hives, certain ailments like liver and kidney problems, allergic reactions to some foods or chemicals, reactions to certain antibiotic and antifungal drugs, and complications during pregnancy.

Treatments

A major part of treating pruritus involves addressing any underlying skin condition that may be causing the itch. Itching due to dry skin is usually controlled with simple emollients that can be prescribed or purchased over the counter. Oral antihistamines are particularly effective for insect bites. Topical corticosteroids are used to relieve inflammatory skin problems like atopic dermatitis (eczema). Itching caused by chronic kidney disease is treated using the drug Gabapentin. Hodgkin’s lymphoma is addressed using Cimetidine and corticosteroids. Paroxetine is used for paraneoplastic itch. Patients that are HIV-positive and experiencing pruritus as a result, are treated with the drug Indomethacin. Uraemia is an itch-inducing condition that can be treated using Nalfurafine, Thalidomide, or Naltrexone. Polycythaemia Vera is another condition, which is treated using aspirin and paroxetine. General itching can also be reduced through application of Calcineurin inhibitors or cannabinoids, as they act on neuro-receptors on the sensory nerve fibres of skin. Itch due to conditions like HIV and chronic kidney disease have also been successfully treated using ultraviolet (UV) light therapy. Transcutaneous electrical nerve stimulation (TENS), as well as acupuncture, are also used for short-term relief in small-area pruritus.

Self care

Though treatment is mostly dependent on the underlying cause, there are many things you can do to reduce itching and the scratching that follows. For skin hygiene: Shower/bathe with lukewarm or cool water instead of hot. Don’t shower/bathe for too long as this strips the skin of its natural oils and leads to dryness. If at all possible, reduce the frequency of your showers/baths. Avoid soaps that contain harsh chemicals, and use mild bath soaps instead. Pat your body dry instead of rubbing. Use emollients or moisturizers after a bath/shower to prevent dry skin. For clothing: Fabrics like wool can irritate skin, so avoid them and wear silk or cotton instead. Wash clothes with mild detergent. Avoid tight clothing, especially for sleep. Miscellaneous: Cut your nails smooth and short to reduce damage to skin from scratching, and also wear cotton gloves before going to sleep at night.

Drugs used in treating

The drugs used in treating pruritus are generally called antipruritic. They are available as topical (applied directly on skin) or oral (ingested through the mouth). Some treat the underlying cause of the itchy skin, while others act directly. The various classes include antihistamines, corticosteroids, counterirritants, crotamiton, and local anaesthetics.