Prurigo

Pocesuha (prurigo) is the name applied to certain diseases of the skin, characterized by itching. There are two main forms of prurigo: prurigo Gebrs and knotted prurigo Gaida.
Prurigo Gebrs occurs at the end of the first year of life. In USSR at the present time is rare. The etiology is unknown. Noted that usually affects children living in poor hygienic conditions, suffering from vitamin deficiencies and degenerative disorders.
At first the children celebrated urticaria (see) or scrofulous (the so-called children urticaria), which in the third year of life are gradually being replaced by a rash itching badly the size of a pinhead knots color normal skin on the extensor surfaces of the hands and feet (typical localization); on the skin of the trunk rash extremely insignificant. When brushing nodules are covered bloody rind, skin gradually thickens, becomes grayish-brown in color and scaly. Often prurigo is complicated by pyococcal infection in the form of impetigo (see). Very typical lymph nodes, especially inguinal and femoral, and the absence of patients plantar reflex (symptom I. P. Pavlova). Many children show signs of rickets. The disease is chronic, some weakening in the summer. In the hospital they quickly recover, but at home sick again. Suffering severe itching, children do not develop physically; there are disorders of the nervous system. Adults suffer from prurigo rarely; this suggests that children who are suffering prurigo, get better with age.
The differential diagnosis should be deleted scabies.
Treatment: it is necessary to improve living conditions, it is recommended that a long stay in the fresh air, in the summer, sun and sea bathing. Prescribed a tonic and sedatives - calcium, bromine, glitzerofosfata, vitamins C, B1, PP, diphenhydramine, suprastin. Externally antipruritic, particularly the tar, ointments, warm baths and ultraviolet irradiation.
Knotty prurigo Gaida. A rare disease is seen mostly in women 30-40 years. The etiology is unknown, assume connectivity with endocrine disorders and metabolic disorders, sometimes provoke mosquito bites. The disease is characterized by a peculiar itching badly knots value from 2 to 5 mm cyanotic-red color. The surface of knots or glabrous or covered with dense Horny scales. The number of papules different - from one to many, they are localized on the extensor surfaces of the limbs.
Treatment: sedation (for example, trioxazin), and antihistamines. In endocrine disorders - appropriate hormonal therapy. External appointed antipruritic ointments and alcohol rubdown. Separate knots can be destroyed by electrocoagulation, snow carbonic acid or remove surgically.
Cm. also Itching, Neurodermatitis.

Prurigo (lat. prurigo - itching; synonym pocesuha). The term "prurigo" some authors apply only in relation to prurigo Gebrs, others are combined under this name the group of diseases of the skin, characterized by itching and rash nodules elements.
Prurigo Gebrs begins at the end of the first year of life. Are mostly children who live in poor hygienic conditions, suffering from vitamin deficiencies and degenerative phenomena, mainly from the nervous (in particular, the sympathetic system. Children quickly recover in the hospital, but on returning home sick again.
The etiology is unknown. Assume autointoxication, allergies (home allergens), endocrine disorders.
Prurigo Gebrs is extremely rare. At first the children celebrated the rash urticaria, or scrofulous (see Urticaria), which at the end of the 2nd - beginning of the 3rd year of life is replaced by a rash of small (size of a pinhead) tight door, severely itchy, color normal skin, which are located mainly on the extensor surfaces of the upper and lower limbs and very slightly on the skin of the trunk. As a result of combing the nodules are covered bloody crusts, and the skin on the affected areas gradually thickens, becomes grayish-brown in color, becomes dry and scaly small pityriasis scales. In place of separate knots are formed small white scar. Often there is a complication pyococcal infection, most often in the form vulgar impetigo.
Histologically, there is swelling of the papillary and podmoskovnogo layers of the dermis, the expansion of blood and lymphatic vessels, infiltration around them mostly lymphocytes less neutrophils and eosinophils. In the epidermis - moderate sponges and intracellular edema thorn cells.
Celebrated kind of lymph node hyperplasia, mainly inguinal and femoral. Sites sharply increased, pasty consistency, not soldered, painless, not nagnaivajutsja. Characterized by the absence of plantar reflex (symptom I. P. Pavlova). Many children show signs of rickets. Typical white dermographism. In blood reasonable eosinophilia. The disease is chronic, several getting better in the summer. Due to the constant itching children become nervous, bad develop mentally and physically. What prurigo Gebrs in adults occurs only rarely, suggests that sick children or better, or die from intercurrent diseases. The diagnosis should first eliminate parasitic itching disease, in particular scabies.
Treatment. You must create ill good living conditions. It is recommended for a long stay in the fresh air, heliotherapy, sea bathing. Inside sedatives (bromine, calcium), vitamins (C, B1 PP and others), and antihistamines. Locally appointed antipruritic funds in the form of creams, ointments, pastes. Especially shows drugs tar. Useful warm baths, General ultraviolet irradiation.
Prurigo nodularis (Hyde) [SYN: Lichen obtusus, neurodermitis nodularis, urticaria perstans (papulosa)] is a relatively rare disease of the skin that occurs mostly in women 30-40 years. The etiology and pathogenesis is not clear. It is supposed communication with the endocrine (ovarian) disorders, metabolic, autointoxication. Sometimes the nodules R. nodularis occur on the site of the bite of blood-sucking insects (mosquitoes).
Prurigo nodularis characterized by episodes of severe itching and rash dense, semispherical shape nodes in size from a pea to cherries and even nutmeg. The color of their first pink, in subsequent cyanotic. The surface of the skin rash smooth, flat or covered with dense Horny scales that gives them warty appearance. Often the Central part of nodes due to scratching is covered with bloody crust. The rash can be singular and plural. Their main localization - extensor surfaces of the upper and lower extremities, and rarely, the skin of the trunk.
Histologically found acanthosis and more or less pronounced hyperkeratosis; in the dermis - lymphohistiocytosis infiltration, swelling of vascular endothelium and, particularly, the significant growth of nerve fibers, forming some kind of a neuroma. A long, nodules exist for years. Only very rarely some of them are involution with the formation of surface atrophic scar.
Treatment with little success. To reduce severe attacks of itching recommended to administer sedatives, tranquilizers (chlorpromazine, trioxazin and others). When expressed endocrine disorders - hormone therapy. Local antipruritic funds, mainly in the form of alcohol rubdowns. Individual nodes can be destroyed (caustic soda, surgical diathermy, cryotherapy) or to remove it surgically.
Cm. also Itching, Neurodermit.