Modern concept of pruritus diagnosis and therapy

Abstract

Modern concept of pruritus diagnosis and therapy Abstract. Pruritus can be best treated when the cause of itching is known, allowing a targeted treatment. To find the cause of itching it is recommended to consult the itch classification system of the «International Forum for the Study of Itch» (IFSI). In here three groups of conditions are distinguished: Pruritus on diseased (inflamed) skin (group I) is caused by a pruritic skin disorder that has to be diagnosed properly; correct treatment of the skin disorder will be the treatment of pruritus. Pruritus on non-diseased (non-inflamed) skin (group II) can be due to an internal disease or a consequence of drugs; elimination of the cause - as far as possible - will also eliminate itch. In pruritus presenting with severe chronic secondary scratch lesions (group III) the aim will be to prevent patients from further scratching. If causative treatment is not possible or the cause of itch remains unknown a symptomatic treatment will be seeked following a step-by-step procedure. In a step 1 a basic therapy with moisturizers and anthistamines is recommended. Step 2 comprises a symptomatic causative adapted therapy. In step 3 phototherapy and systemic treatments are considered including the use of anticonvulsants, antidepressants or anti-inflammatory agents.