Evaluation and treatment of "psychogenic" pruritus and self-excoriation.

SUNY Health Science Center, Brooklyn 11203.
Journal of the American Academy of Dermatology (Impact Factor: 4.91). 07/1994; 30(6):993-9. DOI: 10.1016/S0190-9622(94)70125-3
Source: PubMed

ABSTRACT Psychogenic pruritus and self-excoriation are diagnoses of exclusion. Elimination of traditional organic causes often leads the clinician to label a symptom as psychogenic in origin and limits treatment options. This article examines the organic and psychologic causes and concomitants of dermatologic conditions associated with pruritus and self-excoriation. An organized cognitive framework is presented to guide the clinician in the evaluation and treatment of these patients. Specific treatment options are offered and relevant psychopharmacologic agents are reviewed.

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    ABSTRACT: I would like to propose my opinions regarding whether psychogenic pruritus exists and how it could be defined. I also consider whether `functional itch disorder' or `somatoform itch' are more appropriate terms. In addition, we address how it can be understood, whether similar disorders exist, whether it is related to pleasure and how to diagnose and treat the patient. In our opinion, psychogenic pruritus does exist and is different from the aggravation of itch from other origins. It is aggravated by psychological factors and, therefore, it is necessary to separate the two terms. We believe that the major role of the brain in itch explains its pathophysiogeny.
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