From the Guidelines
Yes, nutritional deficiencies can cause pruritus.
Causes of Pruritus
- Nutritional deficiencies, such as Vitamin D deficiency, can lead to pruritus, as seen in patients with ichthyosis-deafness (KID) syndrome 1.
- Other factors, including iron metabolism disorders, renal disease, hepatic cholestasis, and endocrine disease, can also contribute to pruritus 1.
Investigation and Management
- Checking Vitamin D levels is recommended, especially in patients with risk factors, such as pigmented skin, severity of disease, and winter or spring season 1.
- Supplementation methods are not defined for patients with congenital ichthyoses (CI), but general international recommendations can be followed 1.
- A clinical improvement in CI after short-term high-dose Vitamin D supplementation has been reported in some cases, but maintenance therapy is necessary due to the chronicity of CI 1.
Key Considerations
- Pruritus can be a symptom of various underlying disorders, and excluding secondary causes is crucial for effective management 1.
- Guidelines for the investigation and management of generalized pruritus in adults without an underlying dermatosis are available, but firm evidence-based conclusions are not always possible due to the limited quality of available studies 1.
From the Research
Nutritional Deficiencies and Pruritus
- Nutritional deficiencies can cause pruritus, as evidenced by various studies 2, 3, 4, 5, 6
- Specific deficiencies that have been linked to pruritus include:
- Iron deficiency anemia, which was found to be the most common cause of generalized pruritus in a prospective study 3
- Protein-energy and micronutrient-related malnutrition, which can cause cutaneous signs and symptoms, including pruritus 2
- Niacin deficiency, which can cause pellagra, a condition characterized by an erythematous rash and pruritus 5
- Unsaturated fatty acid deficiency, which has been shown to cause atopic dermatitis-like pruritus in hairless mice 6
- Starch deficiency, which has also been linked to atopic dermatitis-like pruritus in hairless mice 6
Key Findings
- A study published in the Indian Journal of Dermatology found a significant correlation between serum ferritin levels and pruritus, suggesting that iron deficiency may be an underlying cause of generalized chronic pruritus 4
- A study published in the American Journal of Clinical Dermatology found that generalized pruritus was often the primary manifestation of systemic disease, including iron deficiency anemia, hypothyroidism, and chronic lymphocytic leukemia 3
- A study published in Experimental Dermatology found that a diet deficient in unsaturated fatty acids and starch caused atopic dermatitis-like pruritus in hairless mice, which was alleviated by supplementation with linoleic acid or wheat starch 6