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Itching and PBC

Primary biliary cirrhosis (PBC) is a liver disease of unknown etiology characterized by the presence of anti-mitochondrial antibodies in serum, chronic non-suppurative cholangitis on liver histology and cholestasis Itch is the most common symptom associated with PBC. It has been reported to occur in 25–70% of patients with PBC.  Here is a good article on itch in PBC:   Download Itch PBC  

What worked the best for these patients was antihistamines, cholestyramine and prednisone.  The latter may be associated with unacceptable side-effects with long-term use.

Chronic Itching

Here are three excellent reviews which will help with the diagnosis and management of patients with chronic itching.

1. Somatic and Psychiatric considerations:  Download Chronic Pruritus

2. Guidelines on Chronic Pruritus from the European Dermatology Forum: Download Guideline-on-Chronic-Pruritus

3. Clinical Classification of Itch: a Position Paper  Download Clinical Classification of Itch

These are very helpful articles for physicians and lay persons with itch-related disorders.

Itching in the Elderly

"The most common skin complaint in the elderly is pruritus. The multitude of variables that come with advanced age means that the management of pruritus in the elderly poses a particular therapeutic challenge. Pruritus in advanced age may result from a variety of etiologies, although xerosis is the most common. In addition, certain cutaneous and systemic diseases that are associated with pruritus are more prevalent in the elderly. At present, there is no universally accepted therapy for pruritus. Currently, management of pruritus in the elderly must take an individualistically tailored approach with consideration of the patient’s general health, the severity of symptoms, and the adverse effects of treatment. Physical and cognitive limitations, multiple comorbid conditions, and polypharmacy are some aspects that can influence the choice of treatment in this age group."

The above is the abstract for a good article: "Management of Chronic Pruritus in the Elderly."