Derm: Pruritus: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Pruritus🎧 A clear, high-yield breakdown of this common yet complex itching symptom – perfect for MSRA exam prep and real-world dermatology differentials.🧠 Key Learning Points📌 Definition• Pruritus is an unpleasant sensation that provokes the urge to scratch• It is a symptom, not a diagnosis – can be acute or chronic (>6 weeks)📌 Causes & Risk Factors• Dermatological: Eczema, psoriasis, contact dermatitis, urticaria• Systemic: Liver disease (cholestasis), kidney failure (uraemia), thyroid dysfunction, malignancy (esp. lymphoma)• Neurological: Post-herpetic neuralgia, MS• Psychogenic: Anxiety, depression, delusional parasitosis• Environmental: Dry skin, heat, irritants• Drugs: Opiates, ACE inhibitors, antibiotics🧠 Mnemonic: “SKIN MAP” – Skin, Kidney, Infection, Neuro, Malignancy, Allergy, Psych📌 Pathophysiology• Triggered by chemical mediators (e.g. histamine, cytokines, serotonin, neuropeptides)• These stimulate itch-specific nerve fibres → spinal cord → brain• Histamine-driven pruritus responds to antihistamines; others may not📌 Symptoms• Generalised or localised itch• Worse at night (suggests systemic causes)• Scratch marks (excoriations), dryness, erythema, lichenification🧠 Clues:Worse after hot bath = polycythaemia veraCrawling sensation = formication → possible delusional parasitosisFamily members affected = scabies📌 Differential Diagnosis• Dermatological: Eczema, psoriasis, urticaria, scabies, lichen planus, fungal infections• Systemic: CKD, liver disease, thyroid dysfunction, haematological malignancies• Neurological: MS, shingles• Psychological: Anxiety, depression• Medications, allergies, environmental causes📌 Diagnosis• Clinical history: Focus on duration, location, systemic symptoms• Skin exam: Check for primary lesions or signs of scratching• First-line tests:FBC, ESR/CRP, ferritinLFTs, U&Es, TFTs, HbA1cConsider CXR if malignancy suspected• Skin biopsy or allergy testing if needed🧠 Red flags: Itch + fever, weight loss, night sweats → think lymphoma📌 Management🎯 Treat the underlying cause:• Manage liver/kidney disease, stop offending drugs, treat infections💊 Symptomatic relief:• Emollients – hydrate skin• Antihistamines – useful for histamine-driven itch (e.g. urticaria)• Topical steroids – eczema, psoriasis• Cholestyramine – cholestatic pruritus• Neuropathic itch – gabapentin, pregabalin• Phototherapy, CBT, habit reversal therapy🧠 Avoid triggers: Heat, harsh soaps, tight clothes📌 Complications• Skin damage → infections, scarring, lichenification• Sleep disturbance, poor concentration, work/social impact• Psychological effects: Anxiety, depression, vicious cycle📌 Prognosis• Depends on underlying cause• Good prognosis if cause is treatable (e.g. drug reaction, infection)• May require long-term symptom control if chronic systemic illness involved📎 More MSRA Resources for Pruritus📝 Revision Notes:https://www.passthemsra.com/topic/pruritus-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/pruritus-flashcards/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/pruritus-accordion-qa-notes/🚀 Rapid Quiz:https://www.passthemsra.com/topic/pruritus-rapid-quiz/🎯 Topic Quiz:https://www.passthemsra.com/quizzes/pruritus/🎓 Full Course:https://www.passthemsra.com/courses/dermatology-for-the-msra/📣 Course MentionThis episode is part of the Dermatology for the MSRA course on PassTheMSRA.com – your go-to hub for structured, exam-aligned revision.👉 Explore all revision notes, quizzes, flashcards, and deep dives at:https://www.passthemsra.com#MSRA #Pruritus #Itching #MSRADermatology #MSRARevision #MSRAFlashcards #MSRAQuiz #MSRATextbook #DermatologyForMSRA #MSRAResources #MSRAQuestionBank #MultiSpecialtyRecruitmentAssessment