Generalized pruritus is an irritating, painful tickling sensation that affects the skin throughout the body or in many areas of a large area. About the causes and treatment of severe itching all over the body with a rash and without with colorful photos will tell you today.
What is generalized itch
Generalized itching is an irritating, painful tickling sensation that affects the skin all over the body or in many areas of a large area and provokes a physiological cardiac reflex. The very concept of pruritus in medicine is not defined with sufficient accuracy, since the physiological and biochemical mechanism of this phenomenon is not clear.
However, it is established that the itching is a sensation close to painful, exciting nerve endings on the border of the epidermis and dermis and causing the need to comb the skin in a certain area. Most often, itching throughout the body is a symptom of a systemic( general) disease, which in any case requires mandatory detection of the cause, that is - accurate diagnosis.
This form of pruritus is characterized by the absence of skin rashes and defects, which is characteristic of a localized form in skin pathologies, manifestation in the form of attacks( often unbearable), increasing at a certain time - usually in the evening or at night. With paroxysmal obtrusive itching, the patient can comb the skin not only with fingernails, but with stiff, pricking objects - combs, brushes - damaging the epidermis( so-called biopsy itching).
In other cases, the patient can suffer from itching, almost always.
What is generalized itch will tell this video:
Modern medicine classifies the itch by its origin. Generalized classification according to Twycross and Bernhard:
- Pruritoreceptive or dermatological. Occurs with inflammation, skin damage, for example, with an insect bite, tick-born acariasis( scabies), hives.
- Systemic( neurogenic) itch , which occurs without the defeat of the nervous system, as one of the symptoms with internal pathologies( liver disease, digestive organs, kidneys, endocrine disorders).
- Neuropathic itch , developing when damaged on one of the central or peripheral links of the nervous system, often combined with a sensitivity disorder. It can be multiple sclerosis, postherpetic neuralgia, traumas that damage the nerve, brain tumors, thromboses and brain abscesses.
- Psychogenic itching is a special, severe form of pruritus that occurs in mental disorders without any symptoms of skin diseases. But severe long-term stresses and experiences can provoke a similar form of itching even in the absence of any disturbances in the psyche.
Very often, generalized pruritus is of mixed origin, so it is difficult to diagnose the true cause of its development.
How to identify a symptom in yourself
Such a pronounced sensation as an itch is easy to detect in yourself, even if the itching is not constant and has moderate intensity.
External itching symptoms:
- excoriation of point or linear character( scratching) on various skin areas
- blood crust;
- appearance on the nail plates of the symptom of "polishing" - the nails become shiny and very smooth, and their edges are stained;
- sleep disorders, nervous system exhaustion.
About the reasons for which there is generalized skin itch, we will tell below.
Possible diseases and disorders
Diseases, which are provocateurs of generalized pruritus, are different in etiology( cause).These can be the following pathologies.
Kidney and liver
- renal diseases , including function deficiency, pyelonephritis, glomerulonephritis, which occur in chronic form( 85% of patients and more) against the background of slow development of uremia( poisoning of the body with toxic substances).Uremic itching can manifest diffusely - throughout the skin - or on the areas: neck, shoulder girdle, external genital organs, extremities, nose. The intensity of this itch usually increases at night, in the summer months, after the dialysis procedure.
- liver disease .A hepatic itching is one of the most intolerable and persistent symptoms of hepatic pathologies that develop against a background of increasing cholestasis - bile retention due to a violation of its outflow. It is observed with giardiasis, pancreatic tumors, in 25% of patients with jaundice, in every 5 patients with hepatitis, in 10% of cases of cirrhosis, as well as with primary sclerosing cholangitis, cholelithiasis. In the case of biliary cirrhosis, itching occurs in almost 100% of patients. Often, itching is an early sign of the disease, appearing 1 or 2 years before other symptoms. Usually more pronounced on hips, abdomen, between fingers, on the skin of the palms and feet.
In addition to skin itching, there are other important symptoms of liver abnormalities:
- nausea, belching with bitterness, vomiting;
- bloating, flatulence, diarrhea, or constipation;
- light( yellow, gray) feces;
- darkening of urine;
- yellowing of the skin, mucous membranes, sclera;
- general malaise, lethargy, headaches.
In blood diseases, itching often spreads throughout the skin, but a particular sign is its intensity in certain areas: with iron deficiency anemia in the intimate area, with Hodgkin's disease( for every 3) with lymphogranulomatosis, above the lymph nodes, especially in the neck area,axillary hollows.
Diffusive itching also occurs with blood cancer, systemic mastocytosis, polycythemia( erythremia), in which it carries an imperishable, pricking, burning character, often - aquatic, that is, pronounced after contact with water.
As in cases of hepatic pathologies, itchy skin itching often occurs before the onset of other symptoms. With polycythemia, itching is worse after a hot bath. It should also pay attention to other serious signs of Hodgkin's disease:
- the patient loses weight;
- observed profuse sweating at night( underwear, wet from sweat);
- fever is possible, followed by a temperature falling below the norm;
- pronounced soreness and enlarged lymph nodes, especially after drinking ethanol;
- is determined by the enlargement of the liver and spleen.
Endocrine, hormonal and metabolic disorders
The causes of itching include endocrine, hormonal and metabolic disorders, which include diabetes mellitus, hyper- and hypothyroidism, menopause, gout, deficiencies of vitamins A and B).
- Diabetic generalized skin itch affects part of the skin of the whole body, but more often affects the zone of the genitals and anus, auditory passages.
- Moderate, unstable itching in hyperthyroidism is observed throughout the torso in 5-10% of patients against the background of the development of thyrotoxicosis.
Hypothyroid pruritus, which is caused by the drying of the skin, is generalized, sometimes manifesting itself very much - right up to the skin lesions during combing.
- development of malignant tumors( melanoma, neoplasm in the stomach, pancreas, glucagonoma, myeloma) in 3% of cases is itching all over the body. Especially often observed with adenocarcinoma and squamous cell carcinoma.
- neurological diseases, psychoneuroses, psychoses, cerebral neoplasms, multiple sclerosis, deep depression, phobias( fears), cause the development of so-called psychogenic itching.
- allergy and the use of certain medications.
Often the whole body itching is suffering from asthma and obstructive pulmonary disease caused by an unidentified allergy, especially during coughing seizures. At this moment all skin is scratched, but especially strongly - in front of the neck - in the pit, on the chest, back.
Acute single itching attacks occur when specific foods are intolerant( peanuts, citrus fruits, fish, tomatoes, cranberries, strawberries).And it is also often provoked by the use of pharmacological drugs, such as:
- ethanol, chlorpropamide;
- antibacterial agents, especially erythromycin, biseptol;
- tolbutamide, oral contraceptives;
- captopril, codeine, aspirin;
- belladonna, opiates, morphine-type drugs, amphetamines, phenothiazines;
- anabolic steroids, antimalarials, salicylates, quinidine.
Autoimmune pathologies and other causes of
- Autoimmune pathologies - bullous pemphigoid, autoimmune hepatitis, celiac disease, type 1 diabetes, biliary cirrhosis;here, many experts also include neurodermatitis;
- lesions by parasites( helminthiases) provoke the itching associated with the immune system response to toxic helminth secretions( ascaris), and may be the only symptom on the skin;
- is a pregnancy in which the itching associated with stagnation of bile in the ducts occurs in the last trimester and completely disappears after delivery.
- age( senile pruritus) is observed in the form of seizures, more often at night and, mainly, in men over 65 years of age.
The causes of this itch are endocrine disorders, dehydration of the skin, xerodermia, atherosclerosis.
Climacteric itching in women can also be diffuse, but more often affects the genital area and anus, underarms, chest, tongue, and palate.
Other generalized itching:
- seasonal itching, appearing in the spring or autumn;
- itching as a reflex response to a strong experience, for example, after an insect bite.
- altitude itching - not too frequent phenomenon, developing at an altitude of 10 thousand meters due to pressure changes.
On what are the 3 main causes of itching all over the body, this video will tell:
How to deal with itching all over the body
The presence of itching affecting the entire skin, multiple areas and especially the symmetrical, more often indicates its internal nature, that is,that he is one of the signs of developing disease, sometimes - at the earliest stage. Therefore, the identification of internal pathology that causes itching is the main task of diagnosis and the basis for further development of treatment tactics and simultaneous elimination of itching.
Diagnosing skin pruritus is a very important medical measure, because the acute need to scratch is often preceded by the appearance of serious diseases. First, a so-called physical examination of the patient with an analysis of the skin condition is carried out.
In the presence of rash or skin inflammation of any kind, including papules, vesicles, pustules, scratching, crusts, red and whitish spots, an in-depth study in the dermatologist is required. A patient with an itch is sent to check the presence of dermatozoonoses - various skin diseases that are caused by the introduction of parasites( or their bites) - mites, worm larvae, blood-sucking insects.
If itching is not associated with dermatosis, the search for other diseases begins. Examination includes:
- mandatory blood test with determination of the number of leukocytes, ESR;
- urine analysis with mandatory detection of protein, sugar, precipitation, microorganisms;
- biochemical blood test( hepatic tests, including indicators of sugar level, ALT, bilirubin, alkaline and acid phosphatase, cholesterol, creatinine, urea, uric acid, and the status of protein metabolism and protein fractions, the amount of iron in the blood serum, in erythrocytes);
- coagulogram( coagulation indices);
- analysis of feces for the maintenance of blood, helminths and their eggs;
- chest X-ray, ultrasound of the liver and heart, thyroid, pancreas, spleen, gallbladder;
- analysis for thyroxine level.
Patients with an itch, whose cause was not immediately identified, periodically undergo a second examination, since the disease causing the need for combing is often manifested later.
With widespread itching, even in the case of a disease that provokes its development, it is difficult to eliminate it. Therefore, above all, eliminate the factors that contribute to the intensification of itching.
- avoid overheating, being in rooms with cool air, it is more often to use cool showers and bathtubs.
- to exclude the touch of the skin of fabrics of synthetic, woolen fibers;
- do not allow contact with irritating chemicals - soap, powders, gels, apply detergents with a lowered pH factor, use moisturizers;
- to exclude the taking of medicines and products that are capable of causing allergic reactions;
- to minimize the use of any means that expand the subcutaneous vessels( caffeine, alcohol), which increases itching, and also - hot water for the shower.
Principles of General Therapy
General etiotropic therapy( treatment of symptoms) includes the use of:
- sedatives, especially necessary for neurogenic, psychogenic itching;
- antiallergic agents, mast cell membrane stabilizers( Ketotifen), calcium preparations, sodium thiosulfate;
- corticosteroids with endocrine disorders, hormones and phytoestrogens with menopausal and senile itching;
- sequestrants( Cholestyramine, Kolestypol), absorbing bile acids and excreting them through the intestines, sorbents, salicylates.
- physiotherapy, which includes: UV irradiation, adrenal inductothermia, electrosleep, contrast shower, sulfur baths and radon baths, cool baths with sea salt;
- external therapy products - powders, emulsions, pastes, ointments, - helping with itching, affecting multiple sites, but the effect of locally acting medications, usually short-term.
It is important that with hepatic itching are almost useless antihistamines cope with allergic itching. Hepatic itching weakens if the following drugs are used:
- sorbents( Polysorb, Polypepane, white and black charcoal), binding and excreting poisons;
- intravenous infusion of funds that purify the blood from toxins;
- hepatoprotectors( Essentiale, Resalyut, Carlsil, Heptral), which restore hepatic cells, ursodeoxycholic acid( with biliary cirrhosis);
- antibiotics for suppuration, anti-inflammatory drugs;
- vitamins and probiotics( Bactistatin, Bififor, Bifiliz, Probiophore), normalizing the beneficial microflora of the digestive system;
- sedative - Phenobarbital;
- choleretic agents that help free flow of bile;
- means, weakening the negative effect of bile on liver cells, improving its passage through the ducts - Rifampicin, Metronidazole. They actively absorb bile acids, reduce their amount in the blood, weakening the itch.
|Pharmacological agents||Names and actions|
|Antihistamines|| Doxepine( Cinequan), Peritol, which help even with neurogenic itching, because it has an antidepressant and sedative effect. |
Suprastin or Diphenhydramine provide a calming effect, so it is more often used in the evening when the itching is worse.
Unfortunately, the drugs that do not cause drowsiness - Claritin, Telfast, Zirtek, Allertec - are ineffective for getting rid of generalized itching. With cholestasis short courses are prescribed Tavegil, Treksil, Feksadin.
|Corticosteroids||Do not relieve widespread itching without manifestations of dermatitis, but are useful if they are combined with moisturizing creams when they are over-dried. Itching with neurodermatitis helps relieve Cynaph-ointment, Hydrocortisone, Elokom, Celestoderm, Bufexamak.|
|Calcineurin inhibitors||Reduces skin inflammation.1% Elidel cream, ointment Advagraf, Prograph|
|Naloxone, Naltrexone( Antakson, Vivitrol)||A good alternative for patients who are not helped by standard antipruritic drugs.|
|UV therapy||Successfully applied for itching against uremia, HIV, erythremia, systemic mastocytosis, urticaria, Hodgkin's lymphoma, with neoplasms in the chest, liver pathologies.|
|Talimidone||Helps in the treatment of pruritus of various origins, especially with renal itching( half the time).|
|Hepatic enzyme inductors||Rifampicin, Phenobarbital when tracking the dynamics of hepatic samples.|
|Cimetidine||Used in the treatment of pruritus with lymphogranulomatosis|
|Antidepressants, tranquilizers||Effective at itching against a background of psychogenic diseases, internal tumors( Paxil, Doxepin)|
|Antiepileptic drugs( Gabapeptin)||Paroxysmal itching in neurological diseases, multiple sclerosis, postherpetic neuralgia|
|Local treatment|| Locally used anesthetics - Lidocaine, Novocain, Anestezin 5-10%, Phenol 1 - 2%, Dimedrol solution 5-10% - reduce skin sensitivityfacilitate moderate itching. Their combination with menthol increases the antipruritic effect. |
Ointments and creams: Capsaicin, which removes strong itching in concentrations up to 0,075%, 5% Cream Doxepin. Acidermum GK, Acriderm Genta, Boromentol, Radevit, Psilo-balm, menthol ointment, Pimecrolimus( Elidel), Sinaflan, Beloderm, Mezdoderm( neurodermatitis, senile, anal-genital itching, eczema, skin tuberculosis), cream-gel Nizulin, Panthenol, Advantan, Baneocin( infections, eczema, bacterial dermatitis), Fucidin, Levomekol, Gystan, Enterosgel( allergic pruritus), A and C Lorinden.
Alternative folk methods
- "Antique" antipruritic products - menthol and camphor ointment, alcohol, phenol, soothing the skin, cool, have a small amount of "pobochek" and are often used with common itching along with oral medications.
- Baths with medicinal herbs and substances, such as: oatmeal, oak bark, fenugreek, starch, chamomile, mulberry, lavender. It should be remembered that any herbal infusion can cause contact dermatitis and allergies.
- For general wiping with diffuse itching use a solution with table vinegar or lemon juice( 3 large spoons for a glass of water), infusion of 20 flowers of chamomile pharmacy into 250 ml of water.
Some popular methods of treatment of pruritus will tell this video: