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Pruritis

Checked: 23-08-2020 by Vicky Ryan Next Review: 23-08-2021

Principles of Management

Generalised itching with no primary skin lesions may suggest systemic causes including cancer. A full history to identify red flag symptoms is vital in uncovering some more serious systemic pathology and guiding appropriate referral.

Local Clinicians recommend the Pruritis clinical guidelines provided by Primary Care Dermatology Society

Pruritis without a rash: http://www.pcds.org.uk/clinical-guidance/pruritus-without-a-rash

In addition NICE (National Institute of Clinical Excellence) suggests a stepped approach to facilitate good clinical practice.

Widespread itch - management: cks.nice.org.uk/itch-widespread#!topicSummary

Pruritis vulvae- management: cks.nice.org.uk/pruritus-vulvae

Pruritis ani- management: cks.nice.org.uk/pruritus-ani

Please always refer to the BNSSG Formulary for the latest prescribing guidance.

Referral

Pruritus with a known underlying cause requires a simple topical regime.

Referral to the Sirona Community Dermatology Service can be considered if further education/treatments are needed, to optimise efficacy and compliance. A skin biopsy is sometimes required for diagnostic purposes and can be performed by the GPwSI if indicated.

Resources

Information on Pruritis and self-care advice – British Association of Dermatology (For both Patients and Health Care Professional’s)

http://www.bad.org.uk/

Itch scratch cycle- Habit reversal for some Patients and psychological support can improve Quality of life for Patients.

http://www.atopicskindisease.com/

Dermatology Life Quality Index (DLQI) assessment.

http://www.dermatology.org.uk/

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.