Catalytic Health

7 Volume 3, Issue 1, May, 2023 System Specific Disorder Dermatologic Xerosis Eczematous dermatitis Urticaria Papulosquamous disorders Infections and infestations Scars Renal End-stage renal disease Liver Cholestatic liver disease Cholestasis of pregnancy Primary biliary cholangitis Endocrine Diabetes mellitus Hyperthyroid Carcinoid syndrome Hematologic Myeloproliferative neoplasm (polycythemia vera, essential thrombocytosis, myelofibrosis) Hodgkin lymphoma Non-Hodgkin lymphoma Multiple myeloma Mastocytosis Iron deficiency anemia Infections Scabies HIV Varicella Superficial fungal infection Onchocerciasis Rheumatologic Sjogren syndrome Scleroderma Dermatomyositis Neurologic Brachioradial pruritus Notalgia paresthetica Postherpetic neuralgia Multiple sclerosis Drug reactions Examples include: opioids/analgesics, chemotherapeutic agents, chloroquine, antibiotics Psychogenic itch Chronic pruritus of unknown origin Table 1. Systemic conditions associated with pruritus; courtesy of Amaris Balitsky, MD and Gwynivere Davies, MD body mass index and lower socio-economic status. Patients with chronic pruritus also had a higher risk of death 7 . While there was no increase in overall malignancy, increased mortality was attributed to a higher risk of hematologic and bile duct malignancies, HR 2.02 (95% CI 1.48–2.75) and 3.73 (95% CI 1.55 – 8.97), respectively 7 . This study suggests that the search for malignancy in the itching patient should focus on specific etiologies, including hematologic and bile duct malignancies. Pathophysiology of pruritus in hematologic malignancy Itch receptors, or polymodal C-fibre nerve endings, are stimulated by pruritogens (e.g., histamine, tryptase, etc) to cause the unpleasant itch sensation. 8 Mast cells and their mediators such as histamine, tryptase, prostaglandins and leukotrienes are involved in the pathogenesis of pruritus. 9 Interleukin (IL)-31 signaling has been identified as central to bridging the immune system with neurons, epithelial surfaces and

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