Prurigo (overview) L28.2

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Itch-bladder addiction; Picker`s nodule; Prurigo diseases; Prurigo Group

Definition
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Etiologically and morphologically heterogeneous group of intensely itchy, papular skin diseases with acute, sub-acute or chronic course. Primary lesions are papules with or without vesicles or intensively itchy, urticarial lesions.

Classification
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The prurigo diseases can be divided as follows:

Diagnosis
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Prurigo test program (varies according to stand)

General laboratory values

  • BSG/CRP
  • CBC with differential blood count
  • iron, ferritin, transferrin
  • calcium, phosphate, creatinine, urea
  • Transaminases (GOP, GPT, GGT) LDH, alkaline phosphatase, bilirubin, hepatitis serology
  • Protein, glucose (Hb A1C)
  • TSH
  • Urine status, possibly creatinine clearance
  • Stool test for occult blood
  • only with anal pruritus: worm eggs, parasites (e.g. Giardia lamblia)

instrumental diagnostics

  • X-ray thorax, X-ray spine (in case of localized itching)
  • Sonography abdomen and lymph nodes

Further examinations depending on the anamnesis and previous findings

  • Protein electrophoresis, possibly immune electrophoresis to exclude paraproteins(MGUS)
  • Antinuclear antibodies (ANA), anti-mitochondrial antibodies (AMA), anti-gliadin antibodies, anti-transglutaminase antibodies (see below dermatitis herpetiformis)
  • Electrolytes, parathormone, porphyrins (see porphyrinemias), iron levels
  • vitamin B12, folic acid, zinc
  • HIV status
  • If necessary, tryptase determination (see mastocytosis)
  • Bacteriological and mycological smears

Therapy
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Note(s)
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In American literature the term "prurigo" is not a common term, except for the prurigo nodularis and the actinic prurigo (Ständer S 2018).

Literature
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  1. Stand S (2018) Pruritus, Prurigo. In: Braun-Falco`s Dermatology, Venerology Allergology G. Plewig et al (Hrsg) Springer Verlag S 587
  2. Topal SG et al (2017) The Value of Etiological Tests and Skin Biopsy in the Management of Prurigo Simplex Subacuta. Acta Dermatovenerol Croat 25:276-278.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

Authors

Last updated on: 29.10.2020