Journals / İstanbul Medical Journal / 2019 / Cilt: 20 - Sayı: 3

Factors Affecting the Etiology of Intractable Pruritus in Hospitalized Patients Without Primary Skin Lesions

Yatırılarak Etiyolojik Araştırma Yapılan Primer Deri Lezyonu Olmayan Şiddetli Kaşıntılı Hastalarda Kaşıntı Etiyolojisini Etkileyen Faktörler

Pages
224–230
Publication Date
2022-10-19
DOI
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⚡ TL;DR(Too Long; Didn't Read)

Multivariateanalyses revealed that acute onset of pruritus increased therisk of UDOP by 15.28 times (p=0.005, 95% confidence interval(CI): 2.30-101.67) compared to patients with chronic onset.The lack of sleep disorders increased the risk of UDOP by 8.22times (p=0.01, 95% CI: 1.67-40.56) compared to patients whohad sleep disorders.Conclusion: Acute onset of pruritus and lack of sleep disorderswere independent predictors of UDOP in patients with SSLs.The remaining patients without UDOP should be directed to therelevant departments for accurate diagnosis and management.

📌 3 Key Takeaways

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Objective & Hypothesis:Introduction: Pruritus is a common symptom that hasdermatologic, systemic, neurological, psychogenic, mixed,and unknown causes.
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Key Findings & Data:The aim of this study was to identifythe underlying origin of pruritus (UOP) in hospitalized patientshaving intractable pruritus and presenting with secondaryscratch lesions (SSLs) and to assess the factors affecting UOP.Methods: Data of 95 patients (male/female: 47/48) presentingwith SSLs were examined retrospectively.
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Conclusion & Impact:Multivariateanalyses revealed that acute onset of pruritus increased therisk of UDOP by 15.28 times (p=0.005, 95% confidence interval(CI): 2.30-101.67) compared to patients with chronic onset.The lack of sleep disorders increased the risk of UDOP by 8.22times (p=0.01, 95% CI: 1.67-40.56) compared to patients whohad sleep disorders.Conclusion: Acute onset of pruritus and lack of sleep disorderswere independent predictors of UDOP in patients with SSLs.The remaining patients without UDOP should be directed to therelevant departments for accurate diagnosis and management.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Introduction: Pruritus is a common symptom that hasdermatologic, systemic, neurological, psychogenic, mixed,and unknown causes. The aim of this study was to identifythe underlying origin of pruritus (UOP) in hospitalized patientshaving intractable pruritus and presenting with secondaryscratch lesions (SSLs) and to assess the factors affecting UOP.Methods: Data of 95 patients (male/female: 47/48) presentingwith SSLs were examined retrospectively. Demographic andclinical characteristics, diagnostic procedures, and treatmentagents were recorded. UOP was defined as dermatological andnon-dermatological factors.Results: The median (range) age and disease duration were 61years (11-91) and 2 months (0.06-120), respectively. Prurituswas related to dermatological and non-dermatological reasonsin 78% and 22% of patients. Univariate analysis revealedthat factors showing an association between patients withand without underlying dermatological origin of [pruritus(UDOP)] were age, disease duration, disease onset, ≥3 monthsof continuous drug use, intake of drugs attributed to lead topruritus, accompanying systemic diseases, polypharmacy,renal function tests, and the presence of sleep disorders(p=0.001, p=0.001, p=0.001, p=0.03, p=0.045, p=0.02,p=0.004, p=0.047 and p=0.01, respectively). Multivariateanalyses revealed that acute onset of pruritus increased therisk of UDOP by 15.28 times (p=0.005, 95% confidence interval(CI): 2.30-101.67) compared to patients with chronic onset.The lack of sleep disorders increased the risk of UDOP by 8.22times (p=0.01, 95% CI: 1.67-40.56) compared to patients whohad sleep disorders.Conclusion: Acute onset of pruritus and lack of sleep disorderswere independent predictors of UDOP in patients with SSLs.The remaining patients without UDOP should be directed to therelevant departments for accurate diagnosis and management.

Özet

Amaç: Kaşıntı sık görülen bir belirti olup dermatolojik, sistemik, nörolojik, psikojenik, mikst ve bilinmeyen sebepleri vardır. Bu çalışmanın amacı sekonder deri lezyonları (SDL) ile prezente olan, dirençli kaşıntı nedeniyle hastanede yatan hastalarda kaşıntı etiyolojisini (KET) bulmak ve KET’i etkileyen faktörleri değerlendirmektedir. Yöntemler: Retrospektif olarak SDL olan 95 hasta (erkek/ kadın: 47/48) çalışmaya alındı. Demografik ve klinik özellikler, tanısal işlemler ve tedavi ajanları kaydedildi. KET dermatolojik ve dermatoloji dışı sebepler olarak tanımlandı. Bulgular: Çalışmamızda ortalama (aralık) yaş 61 (11-91) yıl ve hastalık süresi 2 (0,06-120) aydı. Kaşıntı %78 hastada dermatolojik, %22 hastada dermatoloji dışı sebeplerle ilişkili bulundu. Tek değişkenli analiz yaş, ortalama hastalık süresi, akut veya kronik seyir, 3 aydan uzun süre sürekli ilaç kullanımı, kaşıntıya yol açabilecek ilaç kullanımı, eşlik eden sistemik hastalık, polifarmasi, böbrek fonksiyon testleri ve uyku bozukluğu varlığı ile altta yatan dermatolojik sebebe bağlı kaşıntısı (DSK) olan ve olmayan hastalarda ilişki gösterdi (sırasıyla p=0,001, p=0,001, p=0,001, p=0,03, p=0,045, p=0,02, p=0,004, p=0,047 ve p=0,01). Çok değişkenli analiz kronik kaşıntısı olan hastalarla karşılaştırıldığında akut kaşıntısı olan hastalarda DSK riskinin 15,28 kat (p=0,005, 95% CI): 2.30-101,67) arttığını gösterdi. Uyku bozukluğu olan hastalarla karşılaştırıldığında uyku bozukluğu yokluğunun DSK riskini 8,22 kat (p=0,01, 95% CI: 1,67-40,56) artırdığı görüldü. Sonuç: Kaşıntının akut seyirli olması ve uyku bozukluğunun olmaması SDL olan kaşıntılı hastalarda DSK’nin bağımsız prediktörleridir. DSK olmayan hastalar tanı ve tedavi için uygun bölümlere yönlendirilmelidir.

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Cite This Article

KARABULUT, E., AKDOĞAN, N., ÖKTEM, A., HAYRAN, Y., UYSAL, P. İ., YALÇIN, B. (2022). Factors Affecting the Etiology of Intractable Pruritus in Hospitalized Patients Without Primary Skin Lesions. İstanbul Medical Journal, Cilt: 20 - Sayı: 3, 224–230. https://ajindex.com/articles/551970

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