Differential Diagnosis for Generalized Pruritus
Single Most Likely Diagnosis
- Dry Skin (Xerosis): This is often the most common cause of generalized pruritus, especially in older adults or during dry weather conditions. It's a benign condition but can significantly affect quality of life.
Other Likely Diagnoses
- Atopic Dermatitis (Eczema): A chronic skin condition characterized by itchy, inflamed skin. It's common in individuals with a history of allergies or asthma.
- 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 or burn.
- Urticaria: Hives can cause generalized pruritus and are often associated with allergic reactions, infections, or autoimmune conditions.
- Allergic Contact Dermatitis: A type IV hypersensitivity reaction that occurs after exposure to an allergen, leading to itchy, inflamed skin.
Do Not Miss Diagnoses
- Hodgkin Lymphoma: Though rare, Hodgkin lymphoma can present with generalized pruritus as an initial symptom, making it crucial not to miss this diagnosis.
- Chronic Kidney Disease (CKD) or Uremia: Pruritus is a common symptom in patients with advanced CKD or those undergoing dialysis, due to the buildup of toxins.
- Hypothyroidism: Some patients with hypothyroidism may experience dry skin and generalized pruritus.
- Hematologic Disorders (e.g., Polycythemia Vera): Certain blood disorders can cause pruritus, often due to abnormal histamine release or other mechanisms.
Rare Diagnoses
- Neurological Conditions (e.g., Multiple Sclerosis, Neuropathies): In some cases, generalized pruritus can be a symptom of an underlying neurological condition.
- Parasitic Infestations (e.g., Scabies, Pediculosis): Though typically localized, severe infestations can cause generalized pruritus.
- Mastocytosis: A condition characterized by an accumulation of mast cells in one or more organs, which can lead to pruritus among other symptoms.
- Neoplastic Conditions (other than Hodgkin Lymphoma): Certain cancers, like lymphoma or leukemia, can cause generalized pruritus, though this is less common.