Psychogenic Pruritus

Abstract

Pruritus is the most common symptom in dermatology practice. Many times, there is no visible organic cause, and patients complain of severe itching. The relationship between the psyche and itch has been widely studied. The neurobiology of itch involves the complexity of specific mediators, itch-related neuronal pathways, and central processing of itch. Psychogenic itch can be broadly classified into pruritic diseases with psychosocial sequelae, pruritic diseases aggravated by psychosocial factors, and psychiatric disorders causing pruritus. A variety of chemical mediators are involved including, but not limited to, histamine, interleukins, protease-activated receptors, transient receptor potential receptors, opioids, and cannabinoids. Management of psychogenic itch involves a holistic approach to address not only dermatologic and somatosensory aspects, but also the cognitive, emotional, and psychosocial components. Multidisciplinary and liaison clinic could be helpful.