Tehran University Medical Journal

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Pruritus is an unpleasant sensation that provokes the desire to scratch. It has long been recognized as a presenting or concomitant symptom of many systemic diseases. Indeed, generalized pruritus is reported to be associated with underlying diseases in 10-50 percent of cases. This study was conducted to investigate the underlying diseases in pruritic patients without primary skin lesion. Seventy-five patients with at least one-month history of pruritus with no primary skin lesions, presenting to dermatological clinics of Razi Hospital, from April 97 until December 99 were evaluated. The work up procedure consisted of medical history, physical examination, laboratory findings (CBC, ESR, blood chemistry, thyroid function tests, urinalysis, stool exam), chest X-ray and in selected cases, additional specific tests. Fifty-four patients were female, and 21 male the mean age was 45.7y±16.41, and the mean duration of pruritus, 21.8m±21. In 43 patients (75.4 percent), no abnormal finding was detected. Five patients (6.66 percent) had atopy. In the remaining 27 patients (36 percent), the following abnormalities were found: Iron deficiency in 6 patients (8 percent), diabetes mellitus in 6 patients (8 percent), hyperthyroidism in 4 patients (5.33 percent), hypothyroidism in 2 patients (2.66 percent), lymphoma in 3 patients (4 percent), chronic hepatitis, hypocalcaemia, cholelithiasis, psychosis and chronic renal failure each in one patient (1.3 percent). Evaluation of patients with pruritus may be a valuable tool for early detection of underlying systemic diseases.

Keywords: Generalized pruritus, Pruritus and malignancy, Pruritus and internal disease

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