Chronic Pruritus in the Absence of Skin Disease: A Retrospective Study of 197 French Inpatients

Abstract

Chronic pruritus (CP) can occur in the absence of skin diseases, and may be secondary to various causes. The aim of this study was to retrospectively analyse the causes of CP without skin disease in a cohort of patients from the dermatology department, including all patients hospitalized for management of their CP between 2008 and 2018. A total of 197 patients with CP without skin disease were included, mean age 66.7 years, 50.8% men. The main causes identified were psychogenic pruritus (41.1% of patients), neuropathic (36.5%), endocrine (12.2%), haematological (9.6%) and iatrogenic (7.1%) causes. The cause was unknown in 20.8% of patients. Total percent is more than 100 because some patients had several etiologies. Only one aetiology of CP was identified in most patients (69.5%), and 2 aetiologies (in 18.3%) or more (in 12.2%). Concerning symptomatic treatments, emollients were prescribed for 40.6% of patients and topical steroids for 20.3%. Among systemic treatments, gabapentinoids (33%), antidepressants (27.4%) and antihistamines (25.3%) were prescribed. The efficacy of these treatments was rarely complete.

Keywords

• pruritus
• itch
• chronic pruritus
• psychogenic pruritus
• neuropathic pruritus
• systemic pruritus