What is the cause of pruritus (itching)?

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Differential Diagnosis for Itching

  • Single most likely diagnosis
    • Dry skin (xerosis): This is a common condition that can cause itching due to the lack of moisture in the skin, especially during dry weather or in older adults.
  • Other Likely diagnoses
    • Eczema (atopic dermatitis): A chronic skin condition characterized by itchy, inflamed skin, often associated with allergies or asthma.
    • Allergic reactions: Itching can be a symptom of an allergic reaction to substances like insect bites, certain foods, or medications.
    • 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, leading to itching and inflammation.
    • Scabies: A contagious skin infestation by the mite Sarcoptes scabiei, causing intense itching, especially at night.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Malignancy (e.g., lymphoma, leukemia): Itching can be a symptom of certain types of cancer, although this is relatively rare.
    • Liver disease (e.g., primary biliary cirrhosis): Itching can be a symptom of liver disease due to the buildup of bile salts in the skin.
    • Kidney disease: Itching can occur in patients with chronic kidney disease, especially those on dialysis.
    • Thyroid disorders: Both hyperthyroidism and hypothyroidism can cause itching, although this is less common.
  • Rare diagnoses
    • Neurological disorders (e.g., multiple sclerosis, neuropathy): Itching can be a symptom of certain neurological conditions, although this is relatively rare.
    • Insect infestations (e.g., bed bugs, fleas): Itching can be caused by bites from certain insects.
    • Aquagenic pruritus: A rare condition characterized by itching after exposure to water.
    • Cholestasis of pregnancy: A condition that occurs in some pregnant women, causing itching due to the buildup of bile salts in the skin.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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