A number of itchy skin conditions can easily be diagnosed. However, it becomes more difficult with pruritus, which occurs in apparently normal skin or secondary lesions caused by scratching as a result of systemic diseases.

If the pruritus does not stop at all, then the cause must be examined more closely. A detailed medical diagnosis, in which the skin and the internal organs are examined thoroughly, is then important. It is also important for the doctor to know when the pruritus began, whether there were any illnesses in the past and which medication was or is being taken. Also quality, intensity and frequency of pruritus are factors that play a role in the diagnosis. As pruritus is subjective and cannot be measured objectively, the symptom is often assessed via a questionnaire that you as a patient fill out.

An individual and detailed anamnesis, clinical examination as well as interdisciplinary, laboratory chemical and radiological diagnostics are of great importance in the assessment of chronic pruritus. The clinical examination includes a complete inspection of the the entire skin, including mucous membranes, scalp, hair, nails, and anogenital region. An X-ray image of the thorax and a sonography of the abdomen can provide indications of a possible malignant disease.

In addition, the integration of other specialist disciplines (neurology, psychiatry, general medicine, allergology, dermatology, internal medicine [gastroenterology, hepatology, endocrinology, haematooncology], urology, gynaecology, etc.] plays an important role in diagnosis finding.

The identification and treatment of underlying diseases is particularly important in the initial phase of chronic pruritus in order to prevent peripheral and central sensibilisation processes and thus chronification.

Only after all this has been clarified can an individual therapy plan be drawn up. In addition, the skin lesions caused by scratching must be treated. In some cases an inpatient admission is also prescribed.

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