Petruse Liliana, Kiesel Holger, Rampini Silvana K
Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich.
Klinik für Medizinische Onkologie und Hämatologie, Universitätsspital Zürich.
Praxis (Bern 1994). 2020 Nov;109(15):1177-1178. doi: 10.1024/1661-8157/a003596.
CME-Answers: CME: Chronic Generalized Pruritus without Dermatological Cause Chronic generalized pruritus is a common symptom. Dermatological causes must be distinguished from non-dermatological causes. Non-dermatological chronic pruritus has many causes, such as systemic, infectious, neurological, psychogenic disorders, and drug-related side effects, some of which may be associated with significant morbidity. The possibility of systemic disease should be considered in patients with generalized pruritus and no signs of primary skin lesions. In addition to a careful history and physical examination, selected laboratory examinations can be helpful in making a diagnosis. Pruritus can be the first sign of malignant hematological disease. Pruritus associated with solid tumors is not that rare. This article offers an approach to chronic generalized pruritus of adults without concomitant skin changes with a possible clarification strategy and explanation of the most important differential diagnoses.
继续医学教育:无皮肤病因的慢性全身性瘙痒 慢性全身性瘙痒是一种常见症状。必须将皮肤病因与非皮肤病因区分开来。非皮肤性慢性瘙痒有许多病因,如全身性、感染性、神经性、精神性疾病以及药物相关副作用,其中一些可能与严重发病相关。对于有全身性瘙痒且无原发性皮肤损害迹象的患者,应考虑全身性疾病的可能性。除了仔细的病史和体格检查外,选择的实验室检查有助于做出诊断。瘙痒可能是恶性血液病的首发症状。与实体瘤相关的瘙痒并不罕见。本文提供了一种针对无伴随皮肤变化的成人慢性全身性瘙痒的处理方法,以及可能的澄清策略和对最重要鉴别诊断的解释。