Düll M M, Kremer A E
Medizinische Klinik 1, Gastroenterologie, Pneumologie, Endokrinologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland.
Klinik für Gastroenterologie und Hepatologie, UniversitätsSpital Zürich, Universität Zürich, Rämistr. 100, 8091, Zürich, Schweiz.
Dermatologie (Heidelb). 2024 Aug;75(8):597-605. doi: 10.1007/s00105-024-05380-1. Epub 2024 Jun 28.
Chronic pruritus affecting primary non-lesional skin (CPNL) manifests as a common symptom across a spectrum of diseases spanning various medical specialties. Given the diverse etiological factors involved, diagnosing the underlying condition poses a significant challenge.
To provide a comprehensive overview of clinical, laboratory, and imaging diagnostics for CPNL.
A thorough literature search on the diagnostics of chronic pruritus was conducted using PubMed with specific keywords "chronic pruritus AND non-lesional skin", "chronic itch AND non-lesional skin", "chronic pruritus AND diagnostics", "chronic itch AND diagnostics", "CKD-aP", "hepatic pruritus", "cholestatic pruritus", and "myeloproliferative neoplasms AND pruritus".
A systematic diagnostic approach is recommended for patients with CPNL, guided by the prevalence of pruritus-associated diseases. Initial basic diagnostics facilitate a cost-effective and focused evaluation during the initial medical assessment. Information pertaining to underlying diseases can be further refined through specialized diagnostic procedures.
CPNL often presents a diagnostic dilemma. Adopting a stepwise diagnostic strategy facilitates the identification of underlying etiologies, which is crucial for recognizing diseases and administering pruritus-specific pharmacotherapy.
影响原发性非皮损皮肤的慢性瘙痒(CPNL)是跨多个医学专业的一系列疾病的常见症状。鉴于涉及多种病因,诊断潜在疾病是一项重大挑战。
全面概述CPNL的临床、实验室和影像学诊断。
使用PubMed对慢性瘙痒的诊断进行了全面的文献检索,使用的特定关键词为“慢性瘙痒与非皮损皮肤”、“慢性瘙痒与非皮损皮肤”、“慢性瘙痒与诊断”、“慢性瘙痒与诊断”、“慢性肾脏病相关瘙痒”、“肝性瘙痒”、“胆汁淤积性瘙痒”以及“骨髓增殖性肿瘤与瘙痒”。
对于CPNL患者,建议采用系统的诊断方法,以瘙痒相关疾病的患病率为指导。初始基本诊断有助于在初次医疗评估期间进行经济高效且有针对性的评估。有关潜在疾病的信息可通过专门的诊断程序进一步完善。
CPNL常常带来诊断难题。采用逐步诊断策略有助于识别潜在病因,这对于疾病的识别和实施针对瘙痒的药物治疗至关重要。