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Aktuelle Dermatologie 2019; 45(06): 294-305
DOI: 10.1055/a-0711-9717
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© Georg Thieme Verlag KG Stuttgart · New York

Chronischer Pruritus: Epidemiologie, Diagnostik und Behandlung

Chronic Pruritus: Epidemiology, Diagnostics and Treatment
V. Hoffmann
,
M. P. Pereira
,
S. Ständer
Subject Editor: Wissenschaftlich verantwortlich gemäß Zertifizierungsbestimmungen für diesen Beitrag ist Prof. Dr. med. Dr. h. c. Sonja Ständer, Münster.
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Publication History

Publication Date:
05 June 2019 (online)

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In der dermatologischen Praxis ist chronischer Pruritus ein alltägliches Symptom, das viele Patienten belastet. Diverse Dermatosen gehen mit diesem Symptom einher, jedoch liegt nicht immer eine Hauterkrankung dem Symptom des chronischen Pruritus zugrunde. Dieser Artikel gibt eine Übersicht über die verschiedenen Ursachen des chronischen Pruritus und zeigt anhand von Beispielen leitliniengerecht mögliche diagnostische und therapeutische Maßnahmen.

Abstract

Dermatologists encounter daily patients with chronic pruritus, who are severely affected by this condition. Several dermatoses induce pruritus, however a skin disease does not always underlie chronic pruritus. Pruritus is considered chronic when it lasts for at least 6 weeks. In the course of the condition and when severe scratching behavior ensues, chronic prurigo may develop in these patients. A deep understanding of the possible etiologies of chronic pruritus as well as the recommended diagnostic and therapeutic approach is of the utmost importance for dermatologists. The clinical categorization of chronic pruritus in 1) chronic pruritus on inflamed skin, 2) chronic pruritus on normal appearing skin, and 3) chronic pruritus accompanied by chronic scratch lesions is essential for diagnostic and therapeutic guidance.

This article aims to provide an overview on the different possible etiologies of chronic pruritus and resorts to clinical cases to demonstrate recommended diagnostic and therapeutic measures.

Kernaussagen

  • Ab einem Zeitraum von über 6 Wochen spricht man von chronischem Pruritus und im Verlauf der Erkrankung kann sich eine chronische Prurigo bei den Patienten manifestieren.

  • Der chronische Pruritus wird in drei Kategorien eingeteilt:

    • Pruritus auf entzündlicher Haut,

    • Pruritus auf unveränderter Haut und

    • Pruritus bei chronischen Kratzläsionen

  • Bei der Notalgia paraesthetica und dem brachioradialen Pruritus wird ursächlich eine Nervenkompression vermutet.

  • Der nephrogene Pruritus steht häufig in einem engen zeitlichen Zusammenhang mit der Dialyse.

  • Jede Dermatose oder Erkrankung, die CP verursacht, kann sich zu einer CPG entwickeln.

Schlüsselwörter

chronischer Pruritus - Pathophysiologie - klinische Einteilung - Diagnostik - Therapie

Keywords

chronic pruritus - pathophysiology - clinical classification - diagnostics - therapy
 

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