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Psychogenic Pruritus and Its Management.

Anna Buteau1, Jason Reichenberg2

  • 1Internal Medicine, Dell Medical School, The University of Texas at Austin, 601 East 15th Street, CEC C2.470, Austin, TX 78701, USA.

Dermatologic Clinics
|June 23, 2018
PubMed
Summary

Psychogenic pruritus, or itch without a physical cause, can be challenging. Addressing potential psychiatric links is crucial when medical evaluations find no other source for persistent itching.

Keywords:
Chronic pruritusPsychiatric itchPsychogenic itchSomatic symptom disorderSomatoform disorder

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Area of Science:

  • Dermatology
  • Psychiatry
  • Psychosomatic Medicine

Background:

  • Chronic itching (pruritus) presents a diagnostic challenge for clinicians and patients.
  • Patients may resist the notion that psychological factors influence skin conditions.
  • Psychogenic pruritus is defined as itch originating from psychological causes, excluding dermatologic or systemic diseases.

Purpose of the Study:

  • To outline the diagnostic approach for pruritus of unclear origin.
  • To emphasize the importance of considering psychiatric conditions in unexplained itching.
  • To guide healthcare providers in managing patients with suspected psychogenic pruritus.

Main Methods:

  • Standard medical work-up for pruritus, including detailed history and physical examination.
  • Dermatologic examination to rule out skin-specific causes.
  • Laboratory tests and biopsies as indicated to exclude systemic or dermatologic etiologies.

Main Results:

  • A thorough medical evaluation is the first step in diagnosing pruritus.
  • When medical causes are ruled out, psychogenic factors become a primary consideration.
  • Successful management may involve addressing underlying psychiatric conditions.

Conclusions:

  • A comprehensive diagnostic process is essential for all cases of pruritus.
  • Psychogenic pruritus requires a collaborative approach between patient and provider.
  • Integrating psychiatric care can be vital for managing unexplained chronic itching.