Abstract
One of the first steps when attending to patients with pruritus is their examination. This comprises a precise taking of medical history, clinical examination and laboratory tests as well as radiological diagnostics. All of these are of high relevance. Only a comprehensive and precise history and a careful clinical examination can lead to a qualified differential diagnosis of possible underlying causes. This may be completed by laboratory and imaging investigation as well as skin biopsy. The results of all these may enable diagnosing of a certain form of pruritus. This chapter summarizes all relevant steps of the examination of pruritus patients and introduces to an anamnestic algorithm which facilitates the treatment of pruritus patients.
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References
Ambros-Rudolph CM. Dermatosis of pregnancy – clues to diagnosis, fetal risk and therapy. Ann Dermatol. 2011;23:265–75.
Bigby M, Jick S, Jick H, Arndt K. Drug-induced cutaneous reactions. A report from the Boston collaborative drug surveillance program on 15,438 consecutive in-patients 1975–1982. JAMA. 1986;256:3358–63.
Brenaut E, Marcorelles P, Genestet S, Ménard D, Misery L. Pruritus: an underrecognized symptom of small-fiber neuropathies. J Am Acad Dermatol. 2015;72(2):328–32.
Cohen AD, Andrews ID, Medvedovsky E, Peleg R, Vardy DA. Similarities between neuropathic pruritus sites and lichen simplex chronicus sites. Isr Med Assoc J. 2014;16(2):88–90.
Cohen AD, Masalha R, Medvedovsky E, Vardy DA. Brachioradial pruritus: a symptom of neuropathy. J Am Acad Dermatol. 2003;48(6):825–8.
Fett N, Haynes K, Propert KJ, Margolis DJ. Five-year malignancy incidence in patients with chronic pruritus: a population-based cohort study aimed at limiting unnecessary screening practises. J Am Acad Dermatol. 2014;70:651–8.
Lober CW. Should the patient with generalized pruritus be evaluated for malignancy? J Am Acad Dermatol. 1988;19:350–2.
Neilly JB, Martin A, Simpson N, MacCuish AC. Pruritus in diabetes mellitus: investigation of prevalence and correlation with diabetes control. Diabetes Care. 1986;9(3):273–5.
Oaklander AL. Common neuropathic itch syndromes. Acta Derm Venereol. 2012;92(2):118–25.
Oaklander AL. Neuropathic itch. Semin Cutan Med Surg. 2011;30(2):87–92.
Polat M, Oztas P, Ilhan MN, Yalçin B, Alli N. Generalized pruritus: a prospective study concerning etiology. Am J Clin Dermatol. 2008;9(1):39–44.
Ponticelli C, Bencini PL. Pruritus in dialysis patients: a neglected problem. Nephrol Dial Transplant. 1995;10(12):2174–6.
Savk E, Savk O, Bolukbasi O, Culhaci N, Dikicioğlu E, Karaman G, Sendur N. Notalgia paresthetica: a study on pathogenesis. Int J Dermatol. 2000;39(10):754–9.
Savk O, Savk E. Investigation of spinal pathology in notalgia paresthetica. J Am Acad Dermatol. 2005;52(6):1085–7.
Sommer F, Hensen P, Böckenholt B, et al. Underlying diseases and co-factors in patients with severe chronic pruritus: a 3-year retrospective study. Acta Derm Venereol. 2007;87:510.
Ständer S, Weisshaar E, Mettang T, Szepietowski JC, Carstens E, Ikoma A, Bergasa NV, Gieler U, Misery L, Wallengren J, Darsow U, Streit M, Metze D, Luger TA, Greaves MW, Schmelz M, Yosipovitch G, Bernhard JD. Clinical classification of itch: a position paper of the International Forum for the Study of Itch. Acta Derm Venereol. 2007;87(4):291–4.
Stäubli M. Pruritus-a little known iron-deficiency symptom. Schweiz Med Wochenschr. 1981;111(38):1394–8.
Stumpf A, Ständer S. Neuropathic itch: diagnosis and management. Dermatol Ther. 2013;26(2):104–9.
Wahid Z, Kanjee A. Cutaneous manifestations of diabetes mellitus. J Pak Med Assoc. 1998;48(10):304–5.
Weisshaar E, Apfelbacher CJ, Jäger G, et al. Pruritus as a leading symptom – clinical characteristics and quality of life in German and Ugandan patients. Br J Dermatol. 2006;55:957–64.
Weisshaar E, Gieler U, Kupfer J, Furue M, Saeki H, Yosipovitch G, International Forum on the Study of Itch. Questionnaires to assess chronic itch: a consensus paper of the special interest group of the International Forum on the Study of Itch. Acta Derm Venereol. 2012;92(5):493–6.
Weisshaar E, Ständer S, Gieler U, Matterne U, Darsow U. Development of a German language questionnaire for assessing chronic pruritus (AGP-questionnaire): background and first results. Hautarzt. 2011;62(12):914–2.
Weisshaar E, Diepgen TL, Luger TA, et al. Pruritus in pregnancy and childhood – do we really consider all relevant differential diagnoses? Eur J Dermatol. 2005;15(5):320–31.
Yosipovitch G, Goon A, Wee J, Chan YH, Goh CL. The prevalence and clinical characteristics of pruritus among patients with extensive psoriasis. Br J Dermatol. 2000;143:969–73.
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Weisshaar, E., Streit, M. (2016). Examination of Patients. In: Misery, L., Ständer, S. (eds) Pruritus. Springer, Cham. https://doi.org/10.1007/978-3-319-33142-3_11
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DOI: https://doi.org/10.1007/978-3-319-33142-3_11
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