Itch epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogechukwu Hannah Nnabude, MD
Overview
Pruritus is seen in about 4% of the population. It is seen in malignancies, especially hematological malignancies such as polycythemia vera. Uremia and biliary cirrhosis are other diseases in which a significant percentage of patients may have pruritus.
Itch Epidemiology and Demographics
About 280 million people globally, roughly 4% of the world's population, have difficulty with itchiness. [1]
Pruritus may be associated with virtually any malignancy. [2] Certain neoplasms, especially hematologic malignancies, have]] pruritus as a common symptom. For example, patients with polycythemia vera, 48% to 70% have aquagenic pruritus, which is itching that is associated with water coming in contact with the skin. Also, about 30% of people with Hodgkin's disease suffer from pruritus. [3] The incidence of pruritus in other types of hematologic malignancies is currently not known, however, investigators have reported its presence in approximately 3% of patients with non‐Hodgkin's lymphoma [4]. Solid tumors may be associated with paraneoplastic pruritus. In fact, pruritis may one of the early symptoms, starting months or years before a patient is diagnosed. Pruritus is also frequent finding in cutaneous lymphomas. [5] Additionally, it is frequently seen in cancers involving the biliary tract. Retrospective studies have revealed that 2% to 11% of chronic itch cases are attributable malignancies. [6]
Pruritus has been reported to be an early symptom in some non-malignant diseases such as liver disease, renal insufficiency, thyroid disease, Sjögren's syndrome, diabetes mellitus, iron deficiency, paraproteinemia, and other conditions. In internal diseases, itch has been best studied in cholestatic pruritus and uremic pruritus. [7] [8] [6]
About a third of uremic patients treated without dialysis complain of uremic pruritus, and on maintenance hemodialysis, the incidence of uremic itching rises to 70%-80%. [9] [10]
Cholestatic pruritis affects nearly, if not all patients with biliary cirrhosis and is the first symptom in nearly 50% of the patients with this disease [11] Furthermore, the prevalence of pruritus in patients with end‐stage HIV is over 20% [12] [13]
References
- ↑ Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. (December 2012). "Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010". Lancet. 380 (9859): 2163–96. doi:10.1016/S0140-6736(12)61729-2. PMC 6350784. PMID 23245607.
- ↑ Chiang HC, Huang V, Cornelius LA (2011). "Cancer and itch". Semin Cutan Med Surg. 30 (2): 107–12. doi:10.1016/j.sder.2011.05.003. PMID 21767772.
- ↑ Krajnik M, Zylicz Z (2001). "Understanding pruritus in systemic disease". J Pain Symptom Manage. 21 (2): 151–68. doi:10.1016/s0885-3924(00)00256-6. PMID 11226766.
- ↑ Lober CW (1988). "Should the patient with generalized pruritus be evaluated for malignancy?". J Am Acad Dermatol. 19 (2 Pt 1): 350–2. doi:10.1016/s0190-9622(88)80248-2. PMID 3049693.
- ↑ Ahern K, Gilmore ES, Poligone B (2012). "Pruritus in cutaneous T-cell lymphoma: a review". J Am Acad Dermatol. 67 (4): 760–8. doi:10.1016/j.jaad.2011.12.021. PMC 3618025. PMID 22285672.
- ↑ 6.0 6.1 Weisshaar E, Dalgard F (2009). "Epidemiology of itch: adding to the burden of skin morbidity". Acta Derm Venereol. 89 (4): 339–50. doi:10.2340/00015555-0662. PMID 19688144.
- ↑ Metz M, Ständer S (2010). "Chronic pruritus--pathogenesis, clinical aspects and treatment". J Eur Acad Dermatol Venereol. 24 (11): 1249–60. doi:10.1111/j.1468-3083.2010.03850.x. PMID 20846147.
- ↑ Wang H, Yosipovitch G (2010). "New insights into the pathophysiology and treatment of chronic itch in patients with end-stage renal disease, chronic liver disease, and lymphoma". Int J Dermatol. 49 (1): 1–11. doi:10.1111/j.1365-4632.2009.04249.x. PMC 2871329. PMID 20465602.
- ↑ Manenti L, Tansinda P, Vaglio A (2009). "Uraemic pruritus: clinical characteristics, pathophysiology and treatment". Drugs. 69 (3): 251–63. doi:10.2165/00003495-200969030-00002. PMID 19275270.
- ↑ Narita I, Alchi B, Omori K, Sato F, Ajiro J, Saga D; et al. (2006). "Etiology and prognostic significance of severe uremic pruritus in chronic hemodialysis patients". Kidney Int. 69 (9): 1626–32. doi:10.1038/sj.ki.5000251. PMID 16672924.
- ↑ Bergasa NV, McGee M, Ginsburg IH, Engler D (2006). "Gabapentin in patients with the pruritus of cholestasis: a double-blind, randomized, placebo-controlled trial". Hepatology. 44 (5): 1317–23. doi:10.1002/hep.21370. PMID 17058231.
- ↑ Smith PF, Corelli RL (1997). "Doxepin in the management of pruritus associated with allergic cutaneous reactions". Ann Pharmacother. 31 (5): 633–5. PMID 9161661.
- ↑ Uthayakumar S, Nandwani R, Drinkwater T, Nayagam AT, Darley CR (1997) The prevalence of skin disease in HIV infection and its relationship to the degree of immunosuppression. Br J Dermatol 137 (4):595-8. DOI:10.1111/j.1365-2133.1997.tb03793.x PMID: 9390338