Sunday, June 14, 2015

Pruritic Rash

Pruritic Rash
Pruritus simply refers to itching. It can also be linked to a number of other factors such as dryness in the skin, skin infections, pregnancy, and sometimes even cancer. Anyone could be vulnerable to pruritus but there are certain groups that are more prone to the condition such as the ones below:




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  • Diabetes patients.

  • People with HIV/AIDS.

  • Women in their pregnancy experience itching usually on their breasts, hands, thighs, arms or abdomen. It could also be due to eczema that gets worse in pregnancy.

  • Old aged people

  • People with hay fever and seasonal allergies.

  • Patients of respiratory disorders such as asthma


  • Causes


    The rash accompanied with itching can take place either on the whole body or on certain parts, the causes however vary depending upon the overall medical condition of the person. In cases of kidney failure, heart diseases, diabetes rashes are more easily caused. It can also take place as a result of dryness in the skin or an insect bite. Other main causes include:



    • Inflammation or redness of the skin also known as dermatitis.

    • Itchy, scaly skin with some redness also known as eczema.

    • Autoimmune skin disorders such as psoriasis or dermatographism in which red and itchy rashes are formed on the skin.

    • Infections of skin caused by measles, chicken pox, lice or knits in the hair, scabies etc.

    • Skin irritants such as mosquitoes, chemicals in cosmetics and soaps or shampoos, perfumes, poison ivy, certain kind of clothes also cause skin infections.

    • Food allergies are also responsible for Pruritic rashes.

    • Internal Disorders such as liver diseases, leukemia, thyroid, kidney disorder, anemia, and disorders of nervous system can also cause itchy rashes. Neuropathic itching is due to lack of sweat in the affected area.

    •  Multiple sclerosis, excessive medication especially antifungal and narcotic painkillers, shingles etc can also give rashes on various parts of the body.

    • Genital problems such as Vulvovaginal candida as well as vaginal ailments, especially among pre-pubertal females can cause rashes.

    • Sunburn or exposure to extreme weather conditions.

    • Endocrinal disorders such as Hyperthyroidism , Hypoparathyroidism, Myxoedema  or Hypercalcaemia.

    • Pruritic rash is also a major symptom of menopause.




    Diagnosis


    For diagnosing the cause of pruritus the doctors usually conduct a physical examination keeping the following conditions into consideration:




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  • Duration of irritation.

  • Frequency of itching.

  • Amount of redness or swelling.

  • Medical history and other symptoms of the patient.

  • Other types of allergies.

  • Medications if any.

  • Parts of the body where itching is the most.

  • One may also need to undergo a blood test in case the cause is not getting determined. Other skin tests can also be taken such as a scraping or biopsy to be analyzed under the microscope in order to find any infection.



  • How is Pruritus Treated?


    The treatment of pruritus depends majorly on the cause and removal or treatment of the cause to prevent further complications. In a lot of cases, tests are needed to understand the cause. However the best and most important way to treat and prevent pruritus is to look after the skin and protect it from the external factors that cause Pruritic rash.



    • Skin creams, cosmetics such as perfumes, moisturizers, and shampoos should be minimized in use to prevent dryness and itching.

    • Sunscreens should be used to prevent sunburns and other types of skin damages.

    • Soaps and shampoos for daily usage should be mild.

    • Taking shower in warm or cold water is more helpful than hot water.

    • Certain fabrics such as wool, synthetic, nylon should be avoided especially in hot weather as they are the most harmful for skin’s health. Even the bed sheets should be cotton based and soft.

    • In case of severe itching, it is advisable to place some ice over the area.

    • Doctors often prescribe medicines to treat pruritus, such as antihistamines, steroids and antibiotics.

    • Apart from therapies there are topical treatments such as Wet dressings to cool down the skin can also be used.

    • Applying Calamine lotion that contains phenol and has a cooling effect on the skin.

    • It is important to also keep fingernails to be short and clean. If there is an irresistible urge to scratch then one must instead rub the area with the palm.


    If pruritus is severe and sleep is disturbed, then treatment with oral medication may be necessary. Some drugs may help to relieve the itch whilst others are given solely for their sedative effects.


    Medications and drugs



  • Sedating and non-sedating Antihistamines.

  • Antidepressants such as mirtazepine

  • Aspirin is effective sometimes

  • Anti-epileptic drugs like sodium valproate.





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