Swimmer's itch (seven-day eruption after freshwater swimming) Spinal narcotics (pruritus affecting face, neck, and upper chest)Īquagenic pruritus (associated with polycythemia vera, itching within 15 minutes of any water contact)Ĭholinergic urticaria (response to warm water) Glyceryl monothioglycolate (in permanent-wave solution)Īntifungal agents: fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral)ĭrug hypersensitivity: rifampin (Rifadin), vancomycin (Vancocin) Topical medications: benzocaine (Americaine), neomycinĬholinergic urticaria (response to hot bath, fever, exercise) Paint-on tattoos (paraphenylenediamine), tattoo dye (cadmium yellow, mercuric sulfide ) Ointments that are highly concentrated in inert oil Involvement of back, flank, abdomen, waist, and distal extremities Intense itching in elderly patients (often during winter months in northern climates)
Possible photosensitizing cause (e.g., nonsteroidal anti-inflammatory drugs, cosmetics) Hyperkeratotic plaques, pruritic papules, or scalesįace and scalp affected in children but not in adults Plaques on extensor extremities, low back, palms, soles, and scalpīurrows in hand web spaces, axillae, and genitalia Occiput of school-aged children genitalia in adults (sexually transmitted disease) Lesions often located on the flexor wrists “6Ps”: pruritus, polygonal, planar, purple papules, and plaques Papules and pustules at follicular sites on chest, back, or thigh Pruritus out of proportion to appearance of dermatitis Rare vesicular dermatitis affecting lumbosacral spine, elbows, or knees Possible presentation as erythroderma (exfoliative dermatitis) Possible presentation as new eczematous dermatitis in older adults
#Swimmers itch feet skin
Oval eczematous patch on skin with no sun exposure (e.g., buttocks) Initially pruritic urticarial lesions, often in intertriginous areasįormation of tense blisters after urticariaĬutaneous T-cell lymphoma (mycosis fungoides) Involvement of flexor wrists and ankles, as well as antecubital and popliteal fossae
“Itch that rashes (when scratched)” in patients with atopic conditions (e.g., allergic rhinitis, asthma) Reaction within two to seven days of exposure (see Table 2) Sharply demarcated erythematous lesion with overlying vesicles Management of disease-specific pruritus has been established for certain systemic conditions, including uremia and cholestasis. Management of nonspecific pruritus is directed mostly at preventing xerosis. Chest radiography and testing for HIV infection may be indicated in some patients. Diagnostic testing is directed by the clinical evaluation and may include a complete blood count and measurement of thyroid-stimulating hormone, serum bilirubin, alkaline phosphatase, serum creatinine, and blood urea nitrogen levels. Skin scraping, biopsy, or culture may be indicated if skin lesions are present. Causes of systemic pruritus include uremia, cholestasis, polycythemia vera, Hodgkin's lymphoma, hyperthyroidism, and human immunodeficiency virus (HIV) infection. Patients, particularly elderly adults, with severe pruritus that does not respond to conservative therapy should be evaluated for an underlying systemic disease. Effective treatment of pruritus can prevent scratch-induced complications such as lichen simplex chronicus and impetigo.
Pruritus is a common manifestation of dermatologic diseases, including xerotic eczema, atopic dermatitis, and allergic contact dermatitis.
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