The patient reports with either generalized or local itching, may be of recent origin or it may have been there for a few days. Itching provokes scratching at times, till it bleeds. The skin is hot and at times there is red discolouration . this may be present with or without eruptions and with varying modalities. It is a case of PRURITUS.
It is a symptom and a disease by itself. It is present in many conditions including scabies, atopic eczema, candidiasis, urticaria, insect bites, etc. it may be present in systemic conditions without obvious skin involvement, as seen in metabolic disease, malignant disease, haematological diseases, renal and liver diseases. Often senile and psychogenic conditions also present with a lot of itching. Drug reactions can also give these symptoms. It is obvious therefore for the treatment of pruritus that the underlying cause needs to be investigated. This pruritus can be of generalized nature or of local nature.
Pruritus means itching. It can be associated with a number of disorders, including dry skin, skin disease, pregnancy, and rarely, cancer.
Itchy skin can occur without any other noticeable changes on the skin. Or it may be associated with:
Sometimes itchiness lasts a long time and can be intense.
Causes of itchy skin include:
Sometimes the cause of the itching can't be determined.
Anyone can get pruritus but certain groups of people are more susceptible to the condition, including:
Itchy skin that lasts more than six weeks (chronic pruritus) can affect the quality of your life, for example, by interrupting your sleep and causing anxiety or depression. Prolonged itching and scratching may increase the intensity of the itch, possibly leading to skin injury, infection and scarring.
A detailed history, its onset, course and degree of severity must be noted. Investigate any metabolic disease or intake of any drug for another condition. Also note whether the patient is allergic to any physician to correctly pin point the cause of this pruritus. But it often helps to reduce the intensity of itching.
Sulphur is the first remedy the one can think of if the skin texture is dry, scaly and unhealthy, and every little injury suppurates. Skin burns when scratched and is sensitive to air, wind and washing. Eruptions are pimply, pustular with cracks and excoriations on the folds. Itching is aggravated by warmth. Varicose veins ulcerate, rupture and bleed. Redness of orifices.
Sulphur is a potent antiseptic and one off the most important destroyers of scabies, but sulphur has the property to repress constitutional eruptions when applied locally, as well as the power of destroy the acarus.
Sulphur has an independent antipsoric action beyond its property of bringing out the eruptions. It is indicated in cases when psora is active and well indicated remedies fail to act as a consequence.
Psorinum is scabies nosode. Gross described it as a product of psora sicca epidermoid effervescence of pityriasis. Oily skin due to excessive secretion from sebaceous glands. Indolent ulcers, shope to heal. Urticaria, worse on exertion. These excrescences disappear in summer, appear in winter. There is lack of vital reaction and prostration after acute diseases. Foulness of discharges is the second keynote. Profuse perspiration.
Severe itching, leading to disappear; worse at night, from woolens and from the heat of the bed. Scratches until surface in raw and bleeding. Crusty eruptions all over. Eczema, psoriasis, scabies and recurring tendency to lice. Suppressed eruptions.
Arsenicum album has alteration of skin symptoms with internal ailments or asthma. The skin is dry, scaly and shriveled, worse in cold. Eruptions, when present are popular, dry, rough, scaly and worse by cold and scratching. Uriticara with burning and restlessness. Pustules turn malignant, wounds get easily poisoned and infected, gangrene and carbuncles can develop easily. Skin peels off in large scales. Severe itching after suppressed eruptions.
Arsenicum album is closely connected to the cancerous diathesis, and it acts directly upon the cancerous tissues and cancerous elements, and many cures have been reported by it in crude and in potencies. when subjective symptoms are present higher potencies work, and when the similarity is more crude or coarse, lower potencies are useful.
Rhus toxicodendron has intense itching. The skin is dry, hot and burning, itching all over accompanied by burning and smarting, as if pierced with hot needles. scratching is followed by burning. There is a tendency to form scales. Skin is sensitive to cold air.
Tendency to form vesicles, mostly in the supportive form. Rhus toxicondendron is also indicated in shingles, herpes zoster, pemphigus and eczema. It is extremely useful where herpes altrernates with asthma and dysentery.
Natricum muriaticum has a marked action upon herpetic eruptions itching in the flexures; the skin is raw, red and inflamed. Generally the skin is dry and chapped, but is greasy on hairy parts. hives develop after exertion with a lot of burning and itching, worse eating. It also affects the hair follicles causing alopecia. Redness of an old scar, which is painful.
Nettle rash, all over- large, red blotches which itch violently. Itching is better by sweating.
Dolichos pruriens is for violent itching of the skin without any visible eruptions of rash; more across the shoulders, hands, elbows, knees and the hairy parts. Skin burns at night in bed.