Clinical observations of generalized pruritus

Background: Generalized pruritus without primary skin lesion is a heterogenous condition and may persist for long periods, from months to years. Few studies of generalized pruritus have been carried out. Objective: To evaluate the causes, clinical manifestations and treatment courses of generalized pruritus. Methods: A total of 229 new patients (190 newly-visited dermatologie outpatients, 39 consulted inpatients from other clinical departments) with generalized pruritus without skin lesion who visited the Department of Dermatology, Kyungpook University Hospital, Daegu, Korea from July 2005 ~ June 2008 were selected. The data was studied on the basis of a retrospective survey of hospital records. Results: The number of the patients with generalized pruritus was highest in the seventh decade of life. In 57.2% of total patients, generalized pruritus was a symptom of internal disease. Idiopathic pruritus was diagnosed in 20.5% of patients, and senile pruritus in 14.8% of patients. Among internal diseases, endocrine disease was the most common (29.0%). Temperature change was the most frequent aggravating factor (20.3%). For diurnal and seasonal variations, pruritus was frequently aggravated at night (35.9%) and in summer (18.8%). Topical treatment was the most common treatment modality. Conclusion: This study describes the general aspects of generalized pruritus without skin lesion. An approach to the work-up of a patient with pruritus is suggested.