Balak Deepak M W, Kemperman Patrick M J H, Thio H B
LangeLand Ziekenhuis, afd. Dermatologie, Zoetermeer.
Amsterdam UMC, afd. Dermatologie, Amsterdam.
Ned Tijdschr Geneeskd. 2021 Jan 21;165:D5199.
Chronic itch, defined as an itching sensation that persists for more than 6 weeks, is a common complaint that is associated with a high burden of disease. Chronic itch can occur due to a variety of skin diseases, but can also feature as prominent symptom in various internal, neurologic, and psychiatric disorders. Importantly, chronic itch can be drug-related. Determining the underlying cause can be challenging, yet it is an essential step in the management of chronic itch. When generalized chronic itch presents with no primary skin lesions and/or secondary skin lesions, the diagnostic work-up should consist of a detailed history and physical examination with an initial limited screening of laboratory tests. Subsequent additional screening should be dictated by clinical suspicion. In 8% of patients, no underlying cause can be identified: pruritus of unknown origin. The management of chronic itch of unknown origin preferably follows a multimodal approach.
慢性瘙痒定义为持续超过6周的瘙痒感，是一种常见的主诉，与高疾病负担相关。慢性瘙痒可由多种皮肤疾病引起，但也可能是各种内科、神经科和精神科疾病的突出症状。重要的是，慢性瘙痒可能与药物有关。确定潜在病因可能具有挑战性，但这是慢性瘙痒管理的关键步骤。当全身性慢性瘙痒没有原发性皮肤病变和/或继发性皮肤病变时，诊断检查应包括详细的病史和体格检查，并初步进行有限的实验室检查筛查。随后的进一步筛查应根据临床怀疑来决定。在8%的患者中，无法确定潜在病因：不明原因瘙痒。不明原因慢性瘙痒的管理最好采用多模式方法。
