#Is pruritus always more or less generalized?#
No; not infrequently the itching is limited to the genital region (_pruritus scroti_, _pruritus vulvæ_) or to the anus (_pruritus ani_).
#To what may pruritus often be ascribed?#
To digestive and intestinal derangements, hepatic disorders, the uric acid diathesis, gestation, diabetes mellitus, and a depraved state of the nervous system.
Pruritus vulvæ is at times due to irritating discharges, and pruritus ani occasionally to hemorrhoids and seat-worms.
#Is there any difficulty in the diagnosis of pruritus?#
No. The subjective symptom of itching without the presence of structural lesions is diagnostic. In those severe and persistent cases in which excoriations and papules have resulted from the scratching, the history of the case, together with its course, must be considered. Care should be taken not to confound it with pediculosis. In this latter the excoriations usually have a somewhat peculiar distribution, being most abundant on those parts of the body with which the clothing lies closely in contact. (See Pediculosis corporis.)
In pruritus of the genitocrural region the possibility of pediculi being the cause must be kept in mind; an examination of the parts for the parasite or for ova (attached to the hairs) would prevent error. (See Pediculosis pubis.)
#What prognosis would you give in pruritus?#
In the majority of cases the condition responds to proper treatment, but in others it proves rebellious. The prognosis depends, in fact, upon the removability of the cause. Temporary relief may always be given by external applications.
With systemic remedies directed toward a removal or modification of the etiological factors, and, for the temporary relief of the itching, suitable antipruritic applications. In obscure cases, quinia, salophen, lithia salts, calcium chloride, belladonna, nux vomica, arsenic, pilocarpine, and general galvanization may be variously tried. Alkalies prove useful in many cases.
Exceptionally, the relief furnished by external treatment is more or less permanent.
#Name the important antipruritic applications.#
Alkaline baths; lotions of carbolic acid ([dram]j-[dram]iij to Oj), of resorcin ([dram]j-[dram]iv to Oj), of liquor carbonis detergens ([Oz]j-[Oz]iv to Oj), and liquor picis alkalinus ([dram]j-[dram]iv to Oj), used cautiously. One or several ounces of alcohol and one or two drachms of glycerin in each pint of these lotions will often be of advantage, as the following:--