ITCH

Itch (also known as pruritus) is a sensation that causes the desire or reflex to scratch. Itch has many similarities to pain, and while both are unpleasant sensory experiences, their behavioral response patterns are different. Pain creates a withdrawal reflex, whereas itch leads to a scratch reflex.

Causes

Itch can originate in the peripheral nervous system (dermal or neuropathic) or in the central nervous system (neuropathic, neurogenic, or psychogenic). Dermatological conditions, such as eczema, psoriasis, and urticaria, are common causes of itch. Other causes include systemic conditions (for example, liver disease, renal failure, and iron deficiency anemia), infections (such as scabies, fungi, and lice), and allergic reactions to medication, food, or contact allergens.

Pathophysiology

The specific mechanisms underlying itch are complex and involve various mediators, including histamine, which is well-known for its role in allergic reactions. However, non-histaminergic pathways involving substances such as cytokines and opioids also play a significant role. The transmission of the itch sensation involves several types of nerve fibers, including A-delta and C fibers.

Diagnosis

The diagnosis of the underlying cause of itch involves a thorough medical history and physical examination. In some cases, additional tests such as blood tests, skin scrapings, or biopsies may be necessary to identify the cause. Identifying the underlying condition is crucial for effective treatment.

Treatment

Treatment of itch depends on the underlying cause. General measures include moisturizing skin care for dry skin, avoiding irritants, and maintaining a cool environment. Medications may include topical steroids, antihistamines, and, in more severe cases, systemic treatments such as immunosuppressants or biologics. Addressing the primary condition that causes itch is the cornerstone of management.

Prevention

Preventive measures for itch include avoiding known allergens and irritants, using gentle skin care products, and managing any underlying medical conditions that may contribute to itch.

See also

• Dermatology
• Pain management
• Allergy
• Skin care