Itchy skin
Introduction
Introduction Most people have itchy skin, some of which are temporary, occasional, local itchy skin; some are long-term, recurrent, systemic skin itching. The former, such as mosquito bites, local infections of bacteria or fungi on the skin, etc., only need to apply some symptomatic drugs, it will heal in a short period of time. The latter must not be taken lightly, because many clinically intractable, systemic skin itching is often a manifestation of internal lesions on the skin. Itching pruritus refers to a neurological dysfunction in which there is no primary lesion in the clinic and it is mainly pruritus. Skin pruritus is more common in the elderly and middle-aged people, more common in winter and summer. The range of skin itching may be limited to one or two or extensive, or itchy skin. The degree of itching is variable, often intermittent or continuous. Skin pruritus belongs to the category of wind itch in Chinese medicine.
Cause
Cause
1, the concentration of bile acid is too high
When the concentration of bile acid increases in the blood, it will deposit on the skin, causing severe itchy skin. Some cirrhosis, hepatitis, and benign and malignant tumors compress the extrahepatic bile duct, which can cause bile acid retention in the blood due to cholestasis, thereby stimulating itching in the sensory nerve endings in the skin.
2, blood calcium, phosphorus is too high
Excessive levels of calcium and phosphorus in the blood can also cause itching. If the skin is dry at this time, and accompanied by frequent urination, urgency, low back pain, or even urinary water, or less urine, it is necessary to think of kidney disease. Chronic nephritis patients enter the uremia stage, due to increased blood urinary toxins and protein derivatives, often cause systemic skin itching.
3, endocrine disorders
For example, in patients with hyperthyroidism, the skin's blood circulation is accelerated, the skin temperature is increased, causing itchy skin, especially after sleeping. The diabetic patients have more blood sugar, the body's ability to defend against bacteria is reduced, and it is susceptible to bacterial and fungal infections. It can also cause itchy skin.
4, central nervous system diseases
Patients with neurasthenia and cerebral arteriosclerosis often develop paroxysmal itching; patients with brain tumors often cause severe and persistent itching when the lesion infiltrates into the ventricle of the ventricle, and this itching is limited to the nostrils.
5. Some lymphoid tumors
Such as granulomatous granuloma, Hodgkin's disease, etc., early symptoms can often also manifest as systemic itching.
In addition, patients with carcinoid syndrome, chronic leukemia, liver cancer, stomach cancer, lung cancer, colon cancer, prostate cancer, spinal cord tumor, Sjogren's syndrome, hemochromatosis, iron deficiency anemia, etc. can also have varying degrees of systemicity. Itchy skin, and mostly refractory severe itching, that is, the use of antihistamines such as chlorpheniramine, or topical antipruritic drugs such as dermatitis can not be well relieved, so patients should be highly vigilant, promptly go to the hospital for treatment , find out the reasons. Especially in the middle-aged and elderly people, once there is a systemic severe skin itching that has been cured for a long time, it is necessary to follow the doctor's advice and select blood, urine routine, glucose tolerance test, liver and kidney function, tumor-associated antigen and other indicators. You can choose B-ultrasound, CT, gastroscope, colonoscopy, skin or lymph node biopsy, bone wear and other items. Actively look for the cause for appropriate treatment.
Examine
an examination
Related inspection
Skin test blood test
1, skin itching is often the main symptoms of skin diseases, sometimes with rash, scratches, blood stasis, mossy changes and pigmentation.
2, according to the history of the disease, the condition of the diagnosis, such as:
(1) Skin itching is a prominent manifestation, and there is no obvious discomfort in the whole body, mostly dermatological diseases.
(2) A rash caused by allergies, infestation or poisoning of food, drugs, insecticides or other substances, such as paint sores, drug poisoning, powdered sores, fish and crab poisoning, wild wind, water poisoning, sand blast, Asbestos bites, etc., can generally be diagnosed by medical history, and more often accompanied by itching, wind edema, edema and other symptoms.
(3) Old and frail, qi and blood deficiency, its skin itching, mostly blood deficiency and dryness.
(4) Itching caused by mood fluctuations, mostly liver qi stagnation and blood deficiency.
3, skin specialist examination, immunobiochemical examination, such as allergy experiments, sensitization experiments, etc., can help to confirm the diagnosis. Blood routine and urine routine can be checked.
Diagnosis
Differential diagnosis
Differential diagnosis of skin itching:
(1) Infectious skin diseases
Viral skin disease
Chickenpox, measles, flat warts, etc.
2. Bacterial skin disease
Pustular herpes, folliculitis, etc.
3. Fungal skin disease
Head lice, hands, athlete's foot, body lice, femoral hernia, tinea versicolor, etc.
4. Parasitic and animal skin diseases
Hookworm dermatitis, schistosomiasis dermatitis, rash, rickets, mosquito bites, mites dermatitis, mulberry dermatitis, hemorrhoids, etc.
(two) physical skin disease
Scorpion, polymorphic sun rash, sun dermatitis, frostbite, frictional mossy rash, etc.
(three) allergic skin disease
Contact dermatitis, eczema, atopic dermatitis, atopic dermatitis, lipid dermatitis, drug eruption, urticaria.
(four) neurological dysfunction skin disease
Neurodermatitis, scrapie, pruritus, nodular pruritus, pregnancy pruritus, exudative discoids, and dermatitis.
(5) herpetic skin disease
Herpes-like dermatitis, bullous pemphigoid, gestational herpes, herpes-like impetigo, subarachnoid pustulosis, continuous acral dermatitis, palmoplantar pustulosis, etc.
(6) Metabolic skin diseases
Amyloidosis of the skin, mucus edema, and the like.
1, only itching, no skin lesions.
2, itching is mostly paroxysmal, in the emotional impulse, temperature changes, clothing friction, etc., the symptoms appear or increase.
3, sometimes in addition to itching, there are burning, insect crawling, ants walking and other feelings.
4, itching can have scratches, smashing, exudation, scarring and other secondary skin damage. It can change with pigmentation and rough skin for a long time.
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