Itchy skin (Pruritus cutaneus)- this is a peculiar sensation that occurs as a result of the action of an irritant on the body or on the skin and causes the patient to have an uncontrollable desire to scratch the skin. The etiopathogenesis of the disease has not been fully elucidated. However, there is evidence that sensations of itching, tickling and protopathic pain occur when the same nerve fibers are irritated, but only at different impulse frequencies. Itching can appear both when the functions of the conductive part of the nervous system are disrupted, and as a result of processes occurring in the cerebral cortex.
“Itching points” were found in the skin, when touched by Frey hairs, nerve impulses are recorded, spreading along slowly conducting C-fibers to the cortical skin analyzer. In the “itch points” of the subepidermal and basal layers of the epidermis, non-pulpless nerve endings were identified. Itching also occurs in response to irritation of epidermal receptors when insects crawl, when they bite (physiological itching), and also (against the background of redness of the skin, blister) after the introduction of a solution into the epidermis histamine,(1:1000000) or him, liberators (pentamidine, salmin, peptone, compounds 48/80) and after exposure to exo- or endogenous stimuli. It has been established that during immunological or allergic reactions, during intoxication and a number of other pathological processes, proteinases are released and activated from tissues (from the epithelium - cathepsins; from erythrocytes and cellular infiltrates of the skin - leukoproteinases; from plasma - plasmakinins; from mast cells - chymotrypsin-like proteinases). Some proteinases are secreted by fungi and bacteria. The mentioned substances (proteinases), probably and other proteolytic enzymes, in all sorts of pathological processes and extreme conditions of the body, if they penetrate the epidermis and act there on the non-pulp fibers, cause a sensation of itching.
Itching can be in the form of acute attacks (with hypersensitivity to foods, medications, pollen, odors) and in a chronic form (with autointoxication, visceral pathology, helminthiasis, diabetes mellitus, hemoderma, malignant lymphoma, etc.). With a chronic form of itching, the surface of the fingernails becomes polished, sometimes ground off. Traces of scratching appear on the skin in the form of numerous linear bloody crusts, excoriations, and later linear depigmented scars. Gradually, infiltration and lichenification appear, as well as nodules (signs of neurodermatitis).
Itching can be primary (is the only symptom in which there are no primary elements of the rash on the skin) and secondary (accompanies many dermatoses). Primary itching often occurs in emotionally unbalanced individuals as a subjective reaction at the sight of insects (bugs, fleas, lice, worms, etc.) and even at the thought of them, as well as after suffering itchy dermatoses (for example, post-scabiosis conditioned reflex itching, or mnemoderma ), with strong emotions (emotional itching).
From a clinical point of view, primary itching can be generalized (widespread) and localized, or limited (perianal, genital). Generalized itching can be caused by a number of pathological conditions of the body (neuropsychic disorders, tabes, metabolic disorders, diseases of the endocrine system, malignant lymphomas of the skin, mycosis fungoides, lymphogranulomatosis, other hemoderma, tumors of internal organs, constipation, colitis, hemorrhoids, liver and kidney diseases , prostate, female genitalia, stomach, focal infection, etc.), pregnancy (toxicosis), some foods (spices, coffee, cocoa, chocolate, spicy cheese, alcohol, etc.), a number of medications. Generalized itching often accompanies (as a subjective symptom) many dermatoses. There are several types of it.
Senile itch (P. senilis) sometimes occurs (more often in men) over the age of 60 due to dehydration and dry skin, atherosclerosis, prostate hypertrophy, etc.
Winter itch (P. hietnalis) – a seasonal disease manifested by itchy skin, more often on the legs (in people with dry skin).
High altitude itch Occurs in some people when climbing to an altitude of more than 8000 m.
Limited (localized) itching usually occurs in the anus, perineum, scrotum, vulva, scalp, palms.
Itching is often complicated by pyodermatitis.
At treatment itching, first of all, find out its causes and try to eliminate them. Prescribed according to indications bromine, valerian preparations; sibazon (diazepam, seduxen, relanium), chlozepid (librium), trioxazine, phenazepam and other tranquilizers, prozerin; vitamin therapy (B 1, B 6), ATP; antihistamines; antiserotonin drugs with ascorbic acid; sodium thiosulfate; splenin; for senile itching - iodides; with prostate adenoma, prostatitis - reverone, mettestosterone, testenate etc. Externally, alcohol or water are recommended solutions of acetic (2-3%), carbolic (1-4%), salicylic (2-3%) acids, menthol (1-2%), which can also be used as part of a shaken mixture (chatterbox). Also used menthol(0,5-1%) with thymol(0.5-1%) in creams; chlorethone - in the form of an aqueous (0.4%) or alcoholic (1.5-5%) solution. Hydrogen sulfide has a beneficial effect: hydrogen sulfide baths, baths with sea salt, oak bark decoction, string(50-150 g per bath), with bran(300-500 g per bath), thalassotherapy. For localized itching, ointments with corticosteroids have a good effect in the absence of contraindications.
Forecast itching, if its cause is identified and there is a possibility of eliminating it, favorable.
Anyone can experience itchy skin. This problem arises for various reasons, therefore treatment should be prescribed on an individual basis. Itchy skin can be associated not only with diseases of the skin, but also of other organs, so it is important to initially determine the causes and only then engage in direct treatment.
If you have itchy skin, you should first consult a dermatologist. You can undergo examination and cure the disease at the Diana private clinic.
The main causes of itchy skin
Skin itching can be systemic or local. The location of the itching spots can tell your doctor a lot. It is also important to identify other symptoms that may accompany the disease.
In addition to skin diseases, itching can also be caused by pathologies such as Vaquez's disease, Hodgkin's lymphoma, cholestatic jaundice, hepatitis, liver cancer, diabetes mellitus, chronic renal failure, multiple sclerosis. Also, itchy skin can be associated with psychological problems - severe fatigue, depression, constant stress.
If skin itching appears, the first thing to do is consult a doctor and undergo an examination to determine the cause of the symptoms. The doctor conducts a visual examination and prescribes additional tests - blood tests, skin scrapings. Based on the patient's medical history, treatment is prescribed.
Treatment of itchy skin
Treatment for this problem is prescribed solely based on the cause, because itching is just a symptom of the disease. After a complete diagnosis, comprehensive treatment is prescribed.
If the itching is caused by allergies, your doctor may prescribe antihistamines. For fungal infections, treatment with antifungal drugs is required. If the cause of itching is herpes, antiviral drugs, supplemented with immunorestorative therapy, will help. Neurodermatitis is treated with hormonal agents.
When itchy skin, proper body care is important. Itchy areas of the skin can be treated with special ointments or a solution of 3% vinegar; talc-based baby powders are also suitable.
Do not ignore itchy skin, especially if the symptoms do not go away for a long time, because they may indicate the presence of serious diseases in the body. Consult your doctor.
A reaction expressed by the desire to scratch an itchy area. This is a painful sensation in a modified form that occurs with mild irritation of the skin nerve endings responsible for the perception of pain. Some scientists identify specific receptors in human skin that perceive itching.
Causes of skin itching
An important role in the occurrence of the itching mechanism is played by provoking factors, which can be either the body’s own substances (for example, bile salts, histamine) or external factors (for example, wool) that irritate the nerve endings located in the skin. Itch receptors are present only in the upper layer of the skin (epidermis) and mucous membranes (eyes, ears, nose, mouth and throat, anus, urethra, and genitals). They are absent in muscles, joints and internal organs, so there is no itching there. Usually itching is accompanied only by scratching the skin, but in some patients it is accompanied by enlargement of the lymph glands. It may have a special character: piercing, biting, “crawling chills”.
Causes of exogenous (“external”) itching may be insect bites, industrial and household chemicals, temperature changes, endogenous (“internal”) - intoxication of the body due to diseases of the gastrointestinal tract, metabolism (for example, diabetes), cardiovascular disorders (so-called pre-stroke itching) . There are also menstrual itching, pregnancy itching, menopausal itching, and it can also be caused by nervous diseases or various emotions.
Causes of itching can be sweating, dry skin, various infections, allergic reactions, diseases of the liver, kidneys, gastrointestinal tract, hormonal disorders, use of medications, mental causes, etc. Sometimes seeing someone scratching or even talking about itching can trigger an itching reaction in some people.
Classification of skin itching
Generalized skin itching
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Generalized skin itching may be a consequence of food intolerance (spicy foods, smoked foods, mushrooms, citrus fruits, eggs, pork, etc.), the use of medications (antibiotics, etc.), reactions to changes in external temperature (cold itching and heat itching). Itching can also be the result of dry skin due to decreased function of the sebaceous glands (senile itching). Often, generalized skin itching is a consequence of severe general diseases - hepatitis, diabetes mellitus, leukemia, lymphogranulomatosis, malignant neoplasms, etc., and it can precede typical clinical manifestations of the underlying disease long before its diagnosis. Generalized skin itching can be observed in various neuropsychic diseases (neuroses, manic-depressive psychosis, diencephalosis, etc.).
Senile itch- is particularly persistent, mainly in men over 60 years of age. It occurs in paroxysms, mainly at night. The causes are mainly endocrine disorders, atherosclerosis, and skin dehydration.
High altitude skin itch observed when people rise to altitudes above 7,000 m above sea level, it occurs as a result of irritation of baroreceptors.
Solar skin itch due to long-term photosensitivity.
Localized skin itching most often affects the anogenital area(anal itching, scrotal itching, vulvar itching) and scalp. Along with the mentioned etiological factors, localized itching is often provoked by local causes (hemorrhoids, helminthic infestation, proctitis, prostatitis, leucorrhoea, candidiasis, seborrhea, etc.). Localized skin itching is usually paroxysmal in nature. Prolonged existence of itching can lead to complications in the form of pyococcal infection and candidiasis.
Anal itching- occurs in the anus area, causes - pinworms, hemorrhoids, untidy toilet after defecation, constipation, proctitis, prostatitis, use of low-quality toilet paper.
Affects mainly women. The causes may be various inflammatory diseases of the female genital organs, candidiasis, trichomoniasis, skin irritation with urine due to diabetes or gout, menopause, and sexual neuroses. Itching of the genital organs in men is associated with prostatitis, vesiculitis, itching of the head of the penis can be caused by the increased acidity of the vaginal secretion of the sexual partner, or her use of local contraceptives (creams, ointments).
Itching of a different localization. For example, patients with varicose veins often suffer from itching of the legs, which manifests itself during the transition from a vertical to a horizontal lesion. Itching of the lower extremities associated with hypothermia often occurs in winter and is accompanied by dryness and tightness of the skin, as well as redness of individual skin areas. People who neglect the rules of hygiene, as well as, conversely, those who over-wash their hair and thereby dry out their skin, experience itching of the scalp. Itching of the palms, soles, forehead, eyelids, cheeks, shoulder blades, and armpits is usually caused by local vascular or nervous disorders. Itching may occur on any part of the skin after the resolution (healing) of a wide variety of skin rashes.
Itching is often a symptom of a number of skin diseases, such as:
- eczema
- atopic dermatitis
- lichen planus
- scabies
- Dühring's dermatitis herpetiformis, etc.
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As a sensation, itching of the skin is a cortical process that occurs when certain irritants act on the nervous system (see the full body of knowledge Analyzers). Itchy skin can occur when exposed to exogenous and endogenous irritants, as well as when the functions of the central and conductive parts of the nervous system change, as a result of which Itchy skin can be of central or peripheral origin.
There are physiological itching, which occurs in response to adequate irritations (for example, crawling and insect bites), and pathological itching, which occurs in pathological conditions of the body.
Etiology
The reasons that can cause pathological Itching of the skin are extremely diverse. Acute attacks are often associated with hypersensitivity to food or drug allergens (for example, when taking antibiotics, aminazine, belladonna, and others). The chronic form of Itchy skin can be caused by autointoxication that occurs in diseases of the liver, gastrointestinal tract, helminthic infestation, as well as metabolic diseases.
Itching is observed as a concomitant phenomenon with many dermatoses (urticaria, neurodermatitis, eczema, lichen planus, scabies and others), but can also occur independently in the absence of any visible pathological changes in the skin, being the main and only symptom of skin disease, usually in form of painful attacks
Often, itching of the skin is one of the early symptoms of diseases of the hematopoietic organs (leukemia, lymphogranulomatosis), malignant neoplasms, endocrine disorders, nervous and mental illnesses. Considering that itching occurs only in some individuals, it should be assumed that it is based on functional changes in the central nervous system; It is also possible that a purely mental, emotional itching may occur.
The pathogenesis of itching is not well understood. According to most researchers, skin itching is not an independent sensation, but a modified feeling of pain, and only a few authors associate itching with tactile sensitivity. According to G. N. Bishop, skin itching occurs as a result of weak, but often successive irritations of pain receptors transmitting impulses along C fibers, that is, through those that conduct excitation relatively slowly. There is reason to believe that this sensation is perceived by nerve receptors located in the epidermis. The question of the participation in the occurrence of itching in the nervous system, its sympathetic part, as well as the role of histamine, serotonin and adrenaline has not yet been finally resolved. According to Rothman (S. Rothman, 1930), itching can also be caused in desensitized areas of the skin.
Clinically, generalized and localized itching is distinguished. The course varies: from a single acute attack to long-term itching that lasts for months and years. Often, to soothe itching, people resort to friction, stroking, pressure or warming the itchy area of skin and others. As a result of scratching with intense and persistent itching, linear excoriations covered with bloody crusts form on the skin, often complicated by pyococcal infection (see full body of knowledge Pyoderma).
There are varieties of generalized Itching of the skin Senile itching (pruritus senilis) is associated with age-related changes in the skin - atrophic processes in the epidermis, sebaceous and sweat glands, hair follicles and dermis, as well as with the phenomena of atherosclerosis; It is more often observed in men over 60-70 years of age in the form of attacks, mainly at night.
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