Pruritus pp 223-227 | Cite as

Psychogenic Pruritus

  • Laurent Misery


Among extra-dermatological itchings, psychogenic pruritus is sometimes provided as a diagnosis. Unfortunately, it is too often mislabeled as idiopathic pruritus because the patient is anxious or the doctor has no other diagnosis to propose! Think about the movie of Nani Morretti: “Caro diaro”….

The existence of psychogenic pruritus is sometimes discussed by some dermatologists but most of them agree to recognize psychogenic pruritus as a specific disease, which is cited in most reviews about pruritus. Nonetheless, only 31 papers with this key word were referenced by PubMed in July 2007!1

Regarding international classifications of psychiatric diseases, psychogenic pruritus is not cited in the (Inter-national Classification of Diseases-version 10) ICD-10 but pruritus is reported in the diagnosis termed “other somatoform disorders” (F45.8) along with dysmenorrhea, dysphagia, psychogenic stiff neck and bruxism. These disorders are classified among somatoform disorders, which are included in the broader category “neurotic disorders, stress-linked disorders and somatoform disorders.”


Irritable Bowel Syndrome Central Sensitization Multiple Chemical Sensitivities9 Medically Unexplained Physical Symptom Psychogenic Factor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Misery L. Psychogenic pruritus or functional itch disorder. Expert Rev Dermatol. 2008;3:49-53.CrossRefGoogle Scholar
  2. 2.
    Stangier U, Gieler U. Somatoforme Störungen in der Dermatologie. Psychotherapie. 1997;2:91-101.Google Scholar
  3. 3.
    Gieler U, Niemeier V, Brosig B, Kupfer J. Psychosomatic aspects of pruritus. Dermatol Psychosom. 2002;3:6-13.CrossRefGoogle Scholar
  4. 4.
    Fried RG. Evaluation and treatment of “psychogenic” pruritus and self-excoriation. J Am Acad Dermatol. 1994;30:993-999.PubMedCrossRefGoogle Scholar
  5. 5.
    Misery L, Alexandre S, Dutray S, et al. Functional itch disorder or psychogenic pruritus: suggested diagnosis criteria from the French psychodermatology group. Acta Derm Venereol. 2007;87:341-344.PubMedCrossRefGoogle Scholar
  6. 6.
    Stander S, Weisshaar E, Mettang T, et al. Clinical classification of itch: a position paper of the international forum for the study of itch. Acta Derm Venereol. 2007;87:291-294.PubMedCrossRefGoogle Scholar
  7. 7.
    Misery L, Myon E, Martin N, et al. Sensitive skin: psychological effects and seasonal changes. J Eur Acad Dermatol Venereol. 2007;21:620-628.PubMedGoogle Scholar
  8. 8.
    Misery L. Are pruritus and scratching the cough of the skin? Dermatology. 2008;216:3-5.Google Scholar
  9. 9.
    Barnig C, Kopferschmitt MC, de Blay F. Syndrome d’hypersensibilité chimique multiple: phsyiopathologie et clinique. Rev Fr Allergol Immunol Clin. 2007;47:250-252.Google Scholar
  10. 10.
    Gupta MA, Gupta AK. Medically unexplained cutaneous sensory symptoms may represent somatoform dissociation. An Empirical study. J Psychosom Res. 2006;60:131-136.CrossRefGoogle Scholar
  11. 11.
    Richardson RD, Engel CC. Evaluation and management of medically unexplained physical symptoms. Neurologist. 2004;10:18-30.PubMedCrossRefGoogle Scholar
  12. 12.
    Misery L, Chastaing M. Joint consultation by a psychiatrist and a dermatologist. Dermatol Psychosom. 2003;4:160-164.CrossRefGoogle Scholar
  13. 13.
    Consoli SG. ed. Psychiatrie et dermatologie. Paris: Elsevier; 2001.Google Scholar
  14. 14.
    Koblenzer CS. Psychosomatic concepts in dermatology. Arch Dermatol. 1983;119:501-512.PubMedCrossRefGoogle Scholar
  15. 15.
    Misery L. Voies spécifiques du prurit? Ann Dermatol Venereol. 2005;132:1007.PubMedCrossRefGoogle Scholar
  16. 16.
    Darsow U, Drzezga A, Frisch M, et al. Processing of histamine-induced itch in the human cerebral cortex: a correlation analysis with dermal reactions. J Invest Dermatol. 2000;115:1029-1033.PubMedCrossRefGoogle Scholar
  17. 17.
    Drzezga A, Darsow U, Treede RD, et al. Central activation by histamine-induced itch: analogies to pain processing: a correlational analysis of O-15 H2O positron emission tomography studies. Pain. 2001;92:295-305.PubMedCrossRefGoogle Scholar
  18. 18.
    Mochizuki H, Tashiro M, Kano M, Sakurada Y, Itoh M, Yanai K. Imaging of central itch modulation in the human brain using positron emission tomography. Pain. 2003;105:339-346.PubMedCrossRefGoogle Scholar
  19. 19.
    Walter B, Sadlo MN, Kupfer J, et al. Brain activation by histamine prick test-induced itch. J Invest Dermatol. 2005;125:380-382.PubMedGoogle Scholar
  20. 20.
    Savin JA. How should we define itching? J Am Acad Dermatol. 1998;39:268-269.PubMedCrossRefGoogle Scholar
  21. 21.
    Paus R, Schmelz M, Biro T, Steinhoff M. Frontiers in pruritus research: scratching the brain for more effective itch therapy. J Clin Invest. 2006;116:1174-1185.PubMedCrossRefGoogle Scholar
  22. 22.
    van Os-Medendorp H, Eland- de Kok PCM, Grypdonck M, Bruijnzeel-Koomen CA, Ros WJG. Prevalence and predictors of psychosocial morbidity in patients with chronic ­pruritic skin. J Eur Acad Dermatol Venereol. 2006;20: 810-817.PubMedGoogle Scholar
  23. 23.
    Niemeier V, Kupfer J, Gieler U. Observations during an itch-inducing lecture. Dermatol Psychosom. 1999;1:15-19.CrossRefGoogle Scholar
  24. 24.
    Krishnan A, Koo J. Psyche, opioids, and itch: therapeutic consequences. Dermatol Ther. 2005;314-322.Google Scholar
  25. 25.
    Arnold LM, Auchenbach MB, McElroy SL. Psychogenic excoriation. Clinical features, proposed diagnostic criteria, epidemiology and approaches to treatment. CNS Drugs. 2001;15:351-359.PubMedCrossRefGoogle Scholar
  26. 26.
    Ikoma A, Steinhoff M, Stander S, Yosipovitch G, Schmelz M. The neurobiology of itch. Nat Rev Neurosci. 2006;7:535-547.PubMedCrossRefGoogle Scholar
  27. 27.
    Stander S, Schmelz M. Chronic itch and pain - similarities and differences. Eur J Pain. 2006;10:473-478.PubMedCrossRefGoogle Scholar
  28. 28.
    Yosipovitch G, Greaves MW, Schmelz M. Itch. Lancet. 2003;361:690-694.PubMedCrossRefGoogle Scholar
  29. 29.
    Anzieu D. Le moi-peau. Paris: Bordas; 1985.Google Scholar
  30. 30.
    Consoli SG. The “Moi-peau”. Med Sci (Paris). 2006;22:197-200.CrossRefGoogle Scholar
  31. 31.
    van Os-Medendorp H, Eland-de Kok PC, Grypdonck M, Bruijnzeel-Koomen CA, Ros WJ. Prevalence and predictors of psychosocial morbidity in patients with chronic pruritic skin diseases. J Eur Acad Dermatol Venereol. 2006;20:810-817.PubMedGoogle Scholar
  32. 32.
    Schneider G, Driesch G, Heuft G, Evers S, Luger TA, Stander S. Psychosomatic cofactors and psychiatric comorbidity in patients with chronic itch. Clin Exp Dermatol. 2006;31:762-767.PubMedCrossRefGoogle Scholar
  33. 33.
    Misery L, Finlay AY, Martin N, et al. Atopic dermatitis: impact on the quality of life of patients and their partners. Dermatology. 2007;215:123-129.PubMedCrossRefGoogle Scholar
  34. 34.
    Shaw RJ, Dayal S, Good J, Bruckner AL, Joshi SV. Psychiatric medications for the treatment of pruritus. Psychosom Med. 2007;69:970-978.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2010

Authors and Affiliations

  • Laurent Misery
    • 1
  1. 1.Department of Dermatology and Laboratory of Skin NeurophysiologyUniversity of Western BrittanyBrestFrance

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