Psychogenic pruritus

A type of itch with psychological origins

Psychogenic pruritus is a type of itch that is primarily caused by psychological factors rather than direct physical causes. It is a condition where the sensation of itching is not due to any dermatological or systemic disease but is instead linked to emotional or mental states.

Pathophysiology

Psychogenic pruritus is believed to be associated with the complex interaction between the nervous system and psychological factors. The exact mechanism is not fully understood, but it is thought that stress, anxiety, and other emotional disturbances can alter the perception of itch. The central nervous system plays a crucial role in modulating the sensation of itch, and psychological factors can influence this modulation.

Clinical Features

Patients with psychogenic pruritus often present with chronic itching that lacks a clear dermatological cause. The itching can be widespread or localized and may vary in intensity. Unlike other forms of pruritus, there are usually no visible skin changes such as rash or inflammation. However, excessive scratching can lead to secondary skin lesions such as excoriations or lichenification.

Diagnosis

The diagnosis of psychogenic pruritus is primarily one of exclusion. It requires a thorough evaluation to rule out other potential causes of itching, including dermatological, systemic, and neurological conditions. A detailed medical history and physical examination are essential. Psychological assessment may also be necessary to identify underlying emotional or mental health issues contributing to the itch.

Management

Treatment of psychogenic pruritus involves addressing both the psychological and physical aspects of the condition. Psychological interventions such as cognitive behavioral therapy (CBT) can be effective in managing the emotional triggers of the itch. Pharmacological treatments may include antihistamines to reduce itching and antidepressants or anxiolytics to address underlying psychological issues. Stress management techniques and lifestyle modifications can also be beneficial.

Prognosis

The prognosis for psychogenic pruritus varies depending on the individual's response to treatment and the ability to manage psychological factors. With appropriate intervention, many patients experience significant improvement in symptoms.

Related pages

• Pruritus
• Dermatology
• Psychosomatic medicine
• Cognitive behavioral therapy