Aquagenic pruritus
| Aquagenic pruritus | |
|---|---|
| Classification and external resources | |
| Specialty | Lua error in Module:Wikidata at line 446: attempt to index field 'wikibase' (a nil value). |
| ICD-10 | L29.8 (ILDS L29.83) |
| Patient UK | Aquagenic pruritus |
Aquagenic pruritus is a skin condition characterized by the development of severe, intense, prickling-like epidermal itching without observable skin lesions and evoked by contact with water.[1][2]
Presentation
Symptoms occur for up to 35 minutes; duration of an attack is typically between 10 and 120 minutes.[3] However, sensitivity varies among sufferers, and since water is always present to some extent in the air (atmospheric humidity), those with greater sensitivity who live in moister regions are symptomatic almost constantly, while perspiration can cause frequent symptoms even in the driest climates.
Diagnosis
No definitive medical test is known for aquagenic pruritus. Rather, the diagnosis is made by excluding all other possible causes of the patient's itching. Since pruritus is a symptom of many serious diseases, it is important to rule out other causes before making a final diagnosis.
Etymology
The name is derived from Latin: aquagenic, meaning water-induced, and pruritus, meaning itch.
Pathogenesis
The exact mechanism of the condition is unknown, though some studies have suggested the itching occurs in response to increased fibrinolytic activity in the skin.[4][5] Later studies indicated inappropriate activation of the sympathetic nervous system may play a part.[6]
Treatment
Since the cause of the condition cannot be fully avoided in all cases, treatment is usually focused on topical itch management. This can be effected by the application of antipruritic lotions or creams, using phototherapy, or the application of hot or cold packs to the skin after water contact.[4][7] Paradoxically, hot baths or showers help many patients, possibly because heat causes mast cells in the skin to release their supply of histamine and to remain depleted for up to 24 hours afterward.[8] However, the itching associated with aquagenic pruritis is not clearly caused by histamine; other neurotransmitters, such as substance P, may be involved.
H1 and H2 blockers, such as loratadine, doxepin, or cimetidine, have historically been the first line of pharmacological treatment, but not all sufferers find relief with these medications. When antihistamines do work, loratadine seems to be the most effective for mild cases and doxepin most effective for more severe cases.
Naltrexone, hydrocortisone, or propranolol may relieve itching for some people.[7][9][10]
See also
References
Notes
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Further reading
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