Why am I so itchy?

BACKGROUND

Virtually all of us experience an itch at some time. However, for some people, an intense or persistent itch can cause considerable morbidity that often affects the entire family.

OBJECTIVE

This article gives an overview of the problem of itch, and discusses the assessment and management of atopic eczema, scabies, lichen planus and dermatitis herpetiformis.

DISCUSSION: A good history will nearly always provide the diagnosis. Examination can then be targeted at finding specific signs. The distribution of rash is important, as is examination of the nails and mouth. Simple but helpful investigations such as microscopy and skin biopsy can be carried out in the consulting room. If a patient presents with a very itchy rash, consider four main possibilities: eczema, scabies, lichen planus and dermatitis herpetiformis, with the first two being the most common. For chronic conditions such as eczema, structured follow up is essential.