Itch risk factors

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## Overview

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Common risk factors in the development of itch are allergic reactions, cholestasis , diabetes mellitus, and drug side effect.

## Risk factors

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* Exposure to chemicals and plants increases the risk for allergic reactions due to contact such as Urushiol from Poison Ivy or Poison Oak.
* Hepatobiliary disease increases the risk of Cholestasis [1]
* Family history of atopy and dermatologic diseases is associated with increased risk of Skin conditions (such as psoriasis, eczema.
* Excessive sun exposure without proper use of sunscreen puts one at risk of sunburn, especially among people of fairer skin.
* Walking barefoot on moist surfaces, sharing socks and poor foot hygiene increases the risk of athlete's foot [2], while poor scalp care increases the risk of Dandruff.
* Immunosuppression such as in chemotherapy, AIDS, immunosuppresant medications, and poorly controlled Diabetes Mellitus [2] [3] [4]
* Drug Side Effect: acetaminophen, acetylcysteine, acitretin, doxorubicin Hydrochloride, ergotamine tartrate, ethambutol, felbamate, fosphenytoin sodium, hydrochlorothiazide, hydrocodone bitartrate, hydrocortisone butyrate, Hydroxyprogesterone caproate, ketorolac tromethamine, lidocaine (cream), meropenem, mometasone furoate, morphine,naproxen sodium, permethrin, ribavirin, rifampin, tretinoin, triazolam, Trimethoprim, Von Willebrand factor. Also, Photodermatitis can occur when sunlight reacts with chemicals in the skin, leading to the formation of irritant metabolites
* Malignancies such as polycythemia vera and Hodgkin's disease [5] [6]
* Iron deficiency anemia [7]
* Homeless populations, residents of homeless shelters, and people who are exposed to wooded areas have a higher risk of exposure to insect bites, such as those from mosquitoes, ants, and ticks, and unhygienic condition such as Scabies or infection with lice or worms.
* Jaundice as (bilirubin is a skin irritant at high concentrations)
* Pregnancy: as seen in Gestational pemphigoid and Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP)
* Thyroid disease [8]
* End stage renal disease patients are at risk of Uremia [9]
* Xerosis which is dryness of the skin, is the most common cause of itching and is frequently seen in winters. Associated with older age, frequent bathing in hot showers or baths, and high temperature and low humidity environments.

## References

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1. ↑ Decock S, Roelandts R, Steenbergen WV, Laleman W, Cassiman D, Verslype C; et al. (2012). "Cholestasis-induced pruritus treated with ultraviolet B phototherapy: an observational case series study". J Hepatol. 57 (3): 637–41. doi:10.1016/j.jhep.2012.04.023. PMID 22613002.CS1 maint: Multiple names: authors list (link)
2. ↑ 2.0 2.1 Al Hasan M, Fitzgerald SM, Saoudian M, Krishnaswamy G (2004). "Dermatology for the practicing allergist: Tinea pedis and its complications". Clin Mol Allergy. 2 (1): 5. doi:10.1186/1476-7961-2-5. PMC 419368. PMID 15050029.CS1 maint: Multiple names: authors list (link)
3. ↑ Neilly JB, Martin A, Simpson N, MacCuish AC (1986). "Pruritus in diabetes mellitus: investigation of prevalence and correlation with diabetes control". Diabetes Care. 9 (3): 273–5. doi:10.2337/diacare.9.3.273. PMID 3731993.CS1 maint: Multiple names: authors list (link)
4. ↑ Polat M, Oztas P, Ilhan MN, Yalçin B, Alli N (2008). "Generalized pruritus: a prospective study concerning etiology". Am J Clin Dermatol. 9 (1): 39–44. doi:10.2165/00128071-200809010-00004. PMID 18092842.CS1 maint: Multiple names: authors list (link)
5. ↑ Gonçalves F (2010). "Thalidomide for the control of severe paraneoplastic pruritus associated with Hodgkin's disease". Am J Hosp Palliat Care. 27 (7): 486–7. doi:10.1177/1049909110362523. PMID 20231735.
6. ↑ Kantor GR, Lookingbill DP (1983). "Generalized pruritus and systemic disease". J Am Acad Dermatol. 9 (3): 375–82. doi:10.1016/s0190-9622(83)70144-1. PMID 6630598.
7. ↑ Stäubli M (1981). "[Pruritus--a little known iron-deficiency symptom]". Schweiz Med Wochenschr. 111 (38): 1394–8. PMID 7280639.
8. ↑ Mullin GE, Eastern JS (1986). "Cutaneous signs of thyroid disease". Am Fam Physician. 34 (4): 93–8. PMID 3766364.
9. ↑ Narita I, Iguchi S, Omori K, Gejyo F (2008). "Uremic pruritus in chronic hemodialysis patients". J Nephrol. 21 (2): 161–5. PMID 18446709.CS1 maint: Multiple names: authors list (link)

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