Differential Diagnosis for Severe Itching
- Single most likely diagnosis
- Atopic Dermatitis (Eczema): This is a common condition characterized by dry, itchy skin, and is often seen in individuals with a history of allergies or asthma. The severe itching can lead to scratching, which further exacerbates the condition.
- Other Likely diagnoses
- Allergic Contact Dermatitis: This condition occurs when the skin comes into contact with an allergen, leading to an immune response and resulting in itching, redness, and blistering.
- Psoriasis: An autoimmune condition that speeds up the life cycle of skin cells, causing cells to build up rapidly on the surface of the skin. The extra skin cells form scales and red patches that itch and burn.
- Dry Skin (Xerosis): Often seen in colder climates or during winter months, dry skin can cause significant itching due to the lack of moisture in the skin.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Hodgkin Lymphoma: Although rare, some types of lymphoma can present with severe itching as an initial symptom, making it crucial not to miss this diagnosis.
- Thyroid Disorders: Both hyperthyroidism and hypothyroidism can cause itching, and while not immediately life-threatening, untreated thyroid disorders can lead to significant morbidity.
- Kidney or Liver Failure: These conditions can lead to the buildup of toxins in the body, which can cause severe itching. Early detection is critical for managing these conditions effectively.
- Rare diagnoses
- Polycythemia Vera: A rare blood disorder that can cause itching, especially after warm baths or showers, due to the release of histamine from basophils.
- Neurological Disorders (e.g., Multiple Sclerosis, Neuropathies): In some cases, neurological conditions can cause itching without a clear skin rash or other dermatological signs.
- Parasitic Infestations (e.g., Scabies, Lice): While not uncommon, these conditions are often overlooked in adults and can cause severe itching, especially at night.