Itching| Other Causes

Etiology

  • Psychogenic
  • Any disease or meds assoc w/cholestasis - can be an acute or chronic disorder
  • Chronic renal disease, uremia
  • Pregnancy related

Symptoms

  • Fatigue, jaundice, edema, dark urine or other directly related to the cause of cholestasis
  • Fatigue, edema, nausea sometimes with uremia
  • Psychogenic itching: A manifestation of obsessive compulsive disorder, delusions, substance abuse
  • Pregnancy related: affects up to 20% of pregnant women; can be idiopathic; related to plaques of pregnancy; related to a pre-existing skin or metabolic issue; or related to cholestasis of pregnancy (typically 2nd or 3rd trimester) w/hand and foot predominance

Physical Exam Findings

  • Might just see excoriations
  • With cholestatic liver disease, might see jaundice, icterus
  • If pregnant, evidence of gravid uterus
  • Might have skin findings during pregnancy (e.g. plaques, papules)

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