| Clinical condition | Clinical manifestations | Postulated mechanism |
| Systemic conditions |
| Uremic pruritus |
- Chronic renal failure
- Not seen with acute renal failure
| - Pruritus usually generalized; may be intermittent or continuous
| - Skin atrophy and dryness
- Secondary hyperparathyroidism
- Accumulation of pruritogenic metabolites
- Abnormal mast-cell proliferation in skin
|
| Cholestatic pruritus |
- Primary or secondary liver disease/malignancy
| - Pruritus may be generalized but is typically worse on the palms and soles
| - Altered opioidergic transmission
- Increased serotonin release
- Increased expression of autotaxin and lysophosphatidic acid
- No correlation between bile acid levels and degree of pruritus
|
| Malignancy related |
- Paraneoplastic
- Hematological disorders
- Solid tumors
| - Aquagenic pruritus in lymphoproliferative disorders
| - Cytokine imbalance in response to tumor-specific antigens
|
| HIV/AIDs |
| | - Pruritus may be generalized or localized, with or without cutaneous lesions
- Localized pruritus with peripheral neuropathy
| |
| Drugs |
| | - With spinal opioids, pruritus usually starts in the upper aspect of the face and nose
- With systemic opioids, pruritus is generalized and may be accompanied with wheal/flare response
| - Centrally mediated by mu-opioid receptor activation of serotonin pathways
|
| Neurologic conditions |
- Brachioradial pruritus
- Postherpetic neuralgia
| - Pruritus follows dermatome pattern
| |
| Dermatological conditions |
| | - Present in the majority of older adult patients
| |
