๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
PSYCHOGENIC PRURITUS
Generalized pruritus can be associated with anxiety disorders, depression, anorexia, and even psychoses (e.g. delusional infestation; see Ch. 7). In true psychogenic pruritus, patients present with a purely sensory complaint (pruritus) without evidence of a delusional component, primary skin disease, or underlying medical condition. It is rare and must be separated from excoriation (skin-picking) disorder, in which a patient creates cutaneous lesions without pre-existing pruritus. The intensity of psychogenic pruritus tends to parallel the emotional state and is often exaggerated. No primary lesions are seen, and secondary lesions range from lichenification to excoriations. Although the patientโs sleep pattern is usually uninterrupted, sedative antipruritics (e.g. doxepin) may be utilized as therapy because topical agents alone are rarely effective. Consultation with a psychiatrist is recommended.