OVERVIEW AND PERSONAL
SWU-MHAM-CM Year III Medical Student,
Dr. Reynaldo O. Joson
Inquiries from Facilitator
inquiries are contained in "text boxes or areas.")
Concept of Pruritus
A. Definition of
It is a disagreeable sensation that provokes a
desire to scratch. It is a primary sensory impulse carried on
unmyelinated C fibers in the spinothalamic tract. It is modulated by
central factors, including cortical ones. Not all cases of pruritus
are mediated by histamine, though several mediators - bradykinin,
neurotensin, secretin, and substance P - release
The sensation of itch may be elicited by a wide
variety of dermatologic disorders and infections or by external
stimuli, such as changes in temperature, stroking, or exposure to
noxious agents. Itching may also be one manifestation of a systemic
disease. Most systemic and cutaneous (delayed-type hypersensitivity)
allergic reactions cause pruritus and often present a most
challenging diagnostic problem.
Technically medically informative!
How about layman concept?
Itchiness, I supposed, that provokes a desire to scratch.
Question: Can you have itchiness on the mucosa? Or is it confined to the
B. Effect of Pruritus on the
health of the individual, family, and community
Once an individual experiences skin problems such
as pruritus, there will be effects and changes that will happen to
his life in such a way that these health problems can alter his
normal function in his body and not only that, economically, the
family where he belongs will also suffer due to the medications that
they buy as well as the doctor's fee too.
However, not only the individual who is affected
but also it has an effect on the family in terms of socio-economic
prosperity. Moreover, the community is also affected in terms of its
socio-economic prosperity for it can hinder its progress in terms of
physical health, economic prosperity and social and moral
In other words, pruritus can affect the biopsychosocial
well-being of individuals who experience it.
It may cause disability. Can it cause death? Pruritus per se?
Pruritus can affect the socioeconomic productivity of
individuals, families, and communities.
II. Common types of
A. Generalized - this refers to the whole part of
the body that becomes pruritic.
B. Localized - this refers to a certain part of
the body that becomes pruritic.
Is there such a thing as mucosal pruritus? If there is,
you can have also classify pruritus into skin and mucosal pruritus.
III. Common causes of
A. Skin Disorders
B. Systemic Disorders
C. Psychogenic Disorders
Which ones are prone to cause generalized pruritus?
Indicate as these may be helpful in clinical diagnosis.
Consider the tabulation I made outside this box.
Also, you may want to change "skin disorders" into focal or primary skin disorders. Systemic and psychogenic disorders
also cause skin disorders.
MAY HAVE LOCALIZED OR
IV. Magnitude of the Health
Problem (Global, National, Local)
There are no clinical records found in the DOH
record section regarding the magnitude of this problem based on its
types and causes. However, individual entities of the disease
associated with pruritus reveals that contact and atopic dermatitis,
eczema, scabies and etc are the more common causes of this skin
Which ones are more common? Localized or generalized
pruritus? Primary skin disorders or systemic disorders
causing pruritus or psychogenic disorders causing
My personal experience tells me that localized is more
common than generalized pruritus. Primary skin disorders
most common. Psychogenic next. Last is systemic disorders.
Can you verify these comparative frequencies?
Remember, always start from general going to specific.
The ones that you mentioned such as contact and atopic dermatitis,
eczema, and scabies, do they cause localized or generalized
pruritus? Are they primary skin disorders or psychogenic
or systemic disorders?
V. Personal perspective on the
possible solutions to the Health Problem
To lessen the magnitude of pruritus and to educate
the people on the approach of detecting such problem.
The people must be taught about the
prevalence/incidence of pruritus, able to detect and able to
understand its occurrence, how to avoid this problem as much as
possible, and disseminate all information about pruritus
Establish and form or organize a group of people
who are willing to volunteer and in upgrading/support the project of
DOH in the community concerned such as:
Target the cause of the pruritic problem rather than
the pruritus itself.
Example, off-hand, I think a primary skin disorders is
more than systemic disorders and psychogenic disorders
as a cause of pruritus. For the primary skin disorders,
allergens, chemicals, and infestations are most common.
I will, therefore, give priority to these problems in
the community health management.
Primary prevention is still the best strategy because
the allergens, chemicals, and infestations are preventable.
Reactions from Dr. Obriz M.
Comments, Questions, and
Reactions from Readers
Paglinawan's Response and Reactions to R.O. Joson's Comments and
and Distance Learning on Skin and Soft Tissue Problems