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Generalised pruritus | Granuloma annulare | Gianotti Crosti syndrome

GENERALISED PRURITUS

This term refers to generalised itching that is not associated with any definite skin disease.

    Causes
  • Obstructive liver disease.
  • Kidney failure.
  • Underlying cancers.
     
    • Lymphoma.
    • Leukaemia
    • Internal cancers.
     
  • Blood disorders.
    • Polycythaemia rubra vera.
    • Iron deficiency anaemia.
     
  • Hormonal disorders
    • Diabetes.
    • Over or under active thyroid.
     
  • Pregnancy (pruritus gravidarum).
  • Parasitic infestations
     
    • Pediculosis (before other signs appear).
    • Scabies (before other signs appear).
    • Intestinal worm infestations.
     
  • Drugs allergies.
  • Psychological causes.
  • Xerosis (dry skin).
  • Senile pruritus.
  • Idiopathic (unknown).
     
    Symptoms
  • Generalised itching which may be worse at night.
  • No signs of skin disease other scratch marks.
     
    What you can do
  • You should consult a doctor to exclude underlying diseases.
     
    What the doctor may do
  • Determine the cause and treat accordingly.
  • If no cause is found, the diagnosis of senile pruritus (if the person is over 79 years) or idiopathic pruritus is made and antihistamines and moisturisers are usually prescribed.
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GRANULOMA ANNULARE

Granuloma annulare is characterised by skin-coloured or pink bumps arranged in a circle or semi-circle It usually affects children and young adults. In rare cases, granuloma annulare can be very widespread and is called generalised granuloma annulare.

    Cause

  • Unknown.
  • Generalised granuloma annulare may be due to underlying diabetes.

    Symptoms

  • Skin coloured or pink bumps arranged in rings or semi-circles around a slightly depressed flat centre.
  • Usually occur on the knuckles, fingers, elbows, ankles, tops of the feet and on the ears.
  • Usually few in number but on rare occasions may be generalised (generalised granuloma annulare).
  • Seventy five per cent of granuloma annulare resolve within 2 years.
      Granuloma annulare.
    Click on image for larger view
    What you can do
  • You should consult a doctor.
     
    What the doctor may do
  • Perform a skin biopsy to confirm the diagnosis.
  • Exclude diabetes.
  • Prescribe topical steroids or inject intralesional steroids or use PUVA for very persistent cases.
  • Leave to heal on their own accord.
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GIANOTTI CROSTI SYNDROME

Gianotti Crosti syndrome is also known as papular acrodermatitis. It usually affects children under the age of 12 years.


    Cause
    Gianotti Crosti syndrome is believed to be a reaction to a virus infection. The viruses implicated include:-
  • Hepatitis B.
  • Epstein Barr virus (the cause of infectious mononucleosis or glandular fever),
  • Coxsackie viruses.
  • Echo viruses.
  • Respiratory syncytial viruses.
  • Polio vaccine enterovirus.
     
    Symptoms
  • Multiple pink or dull red bumps on the face, arm, legs and buttocks.
  • Itching may occur but is uncommon.
  • The lymph glands in the neck, armpits and groins may be slightly enlarged.
  • The child usually feels well although there may be a mild fever.
  • Jaundice may occasionally occur.

    What you can do
  • You should consult the doctor.

    What the doctor may do
  • Prescribe antihistamines if itchy.
  • Prescribe a mild topical steroid cream.
  • The rash usually clears after 1 - 2 months with slight peeling.

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