Pathophysiology of Itch and New Treatments

Ulrike Raap; Sonja Ständer; Martin Metz


Curr Opin Allergy Clin Immunol. 2011;11(5):420-427. 

In This Article

Stepwise Approach in the Diagnosis of Itch

Identifying the cause of patients with chronic itch is a challenge. Before initiating a laboratory investigation or imaging analysis, a careful history of the onset and course of itch, medical history, drug intake et cetera should be performed (Table 1). Further, a clinical examination including the skin, the lymph nodes and dermographism represent an important part in the diagnostic approach of itch (Table 1). Basic laboratory investigations include blood count, differential blood count, besides billirubin and so on, which can also be investigated in depth including, for example zinc, vitamin B12 (Table 1). Diagnostic procedures include the skin biopsy with subsequent specified analysis including histology and direct immunofluorescence. Last but not least, basic imaging analyses are helpful in the diagnostic approach of chronic itch using the chest radiograph and ultrasound of the abdominal part. In-depth analysis includes the computed tomography scan or MRI scan for example in tumor detection as a cause of itch (Table 1).


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