A Simple Guide to Pruritis (Itch), Diagnosis, Treatment and Related Conditions
By Kenneth Kee
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About this ebook
This book describes Pruritis (Itch), Diagnosis and Treatment and Related Diseases
Happiness is having a scratch for every itch - Ogden Nash
I have a female patient who always consulted me for chronic itch of the skin.
Sometimes she will have scratch marks all over her arms and legs and her back with areas of infection and bleeding.
I have advised her to avoid all dusts, soaps and detergents, certain food, stress, animals, etc from her environment and not to scratch. I have asked her to go for skin allergy tests.
With treatment the rash will disappear but it will recur one or two weeks later.
I have also advised her to see a psychiatrist for stress and tension.
Pruritus is the medical term for itch.
Itch is such an unpleasant sensation on the skin that stimulates the desire to rub or scratch the area to obtain relief.
Itch can produce discomfort and frustration; in severe cases it can cause disturbed sleep, anxiety and depression.
Constant scratching to obtain relief can injure the skin (excoriation, lichenification) and decrease its effectiveness as a major protective barrier.
Consistent scratching over a period of time may cause:
1. Lichenification (thickened skin, lichen simplex)
2. Prurigo papules and nodules
Pruritus is often a symptom of an underlying disease process such as a skin disorder, a systemic disorder, or abnormal nerve impulses.
There are no specific skin signs linked with pruritus, besides scratch marks and signs of the underlying disorder.
The skin is the body's largest organ, and itching can be a sign something is not right with the skin.
Itch, like pain, can begin anywhere along the neural itch pathway, from the central nervous system (brain and spinal cord) to the peripheral nervous system and the skin.
The mechanisms underlying pruritus are complicated.
The itch signal is transmitted mostly through small, itch-selective C-fibers in the skin in addition to histamine-triggered and non-histaminergic neurons.
These bind with secondary neurons which cross the opposite side of the spinothalamic tract and go up to parts of the brain involved in sensation, emotion, reward and memory.
These brain regions partly cover those activated by pain.
Patients with chronic pruritus normally have both peripheral and central hyper-sensitization (a heightened reaction) which indicates that they are likely to overreact to noxious stimuli which normally inhibit itch (e.g., heat and scratching) and misinterpret non-noxious stimuli as an itch (e.g., light touch)
The reason why scratching stops the itching has been explained by an interaction with pain pathways within the dorsal horn of the spinal cord.
Depending upon the underlying disorder, itchiness may be linked with other symptoms and signs.
Most often, these linked findings are skin lesions such as rash, blisters, bumps, or redness of the affected area.
Dryness of the skin is a frequent cause of itch.
Itching of skin can cause tears in the skin from scratching.
Less often, generalized itching all over the body can be a sign of chronic medical disorders such as liver disease.
In these circumstances, there may be no alterations to the appearance of the skin.
Stress, anxiety or other emotional disorders can induce itching.
If a skin disorder is responsible for the itch, occasionally a biopsy may be done to identify the disorder.
The treatment of pruritus depends on establishing the underlying disorder and then either removing or treating the disorder to prevent further itching.
TABLE OF CONTENT
Introduction
Chapter 1 Pruritis (Itch)
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Pruritis Ani
Chapter 8 Pruritis Vulvae
Epilogue
Kenneth Kee
Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"
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