Unexplained Skin Itching: Causes and When to Seek Medical Advice

Q: Unexplained Skin Itching: Causes and When to Seek Medical Advice

Dear Mr. Guang： Itching due to skin disorders is commonly associated with the following conditions： 1. Infections： fungal infections, bacterial infections, scabies, and lice infestations. 2. Inflammatory responses： psoriasis, seborrheic dermatitis, pity

Unexplained skin itching?

Hello doctor, at the beginning of May, one morning I woke up and suddenly my knees were itchy, but it stopped after about an hour.
About a week ago, the back of my right hand suddenly became itchy for no apparent reason, which lasted intermittently for about two days before it stopped.
The day before yesterday, after taking a shower, the joint area under my left palm also started to itch for no reason.
I applied some anti-itch cream, which helped a little, but it was still intermittent and lasted about two days.
Today it has finally resolved, and the skin looks normal on the surface.
Recently, I had an abdominal ultrasound that was normal.
Yesterday, I had blood drawn, and my fasting blood sugar was 105.
Two hours after a meal, my blood sugar measured 100 using a glucose meter.
The complete blood count was also normal.
This morning, I measured my fasting blood sugar again with the glucose meter, and it was 90.
I would like to ask if this could be a blood lymphatic disease or if it indicates any signs of a malignant condition?

Guang, 30~39 year old female. Ask Date: 2020/05/20

Dr. Xiao Yongxun reply Family Medicine

Dear Mr.
Guang:
Itching due to skin disorders is commonly associated with the following conditions:
1.
Infections: fungal infections, bacterial infections, scabies, and lice infestations.

2.
Inflammatory responses: psoriasis, seborrheic dermatitis, pityriasis rosea, xerotic dermatitis, contact dermatitis, atopic dermatitis, urticaria, heat rash, lichen planus, and flea bites.
There are many diseases that cause skin itching due to systemic abnormalities, including:
1.
Liver and biliary diseases: such as obstructive jaundice, drug-induced or viral hepatitis, and pregnancy-related cholestasis.
2.
Kidney diseases: such as uremia or acute and chronic kidney disease.
3.
Infections: such as chickenpox, dengue fever, and HIV infection.
4.
Endocrine and metabolic disorders: such as hyperthyroidism or hypothyroidism, and diabetes.
5.
Hematological disorders: such as leukemia, lymphoma, and iron deficiency anemia.
6.
Malignant conditions: such as brain tumors or other malignancies.
7.
Autoimmune diseases: such as systemic lupus erythematosus and dermatomyositis.
8.
Neurological disorders: such as multiple sclerosis and brain tumors.
9.
Psychiatric disorders: such as anxiety disorders, parasitic delusions, and schizophrenia.
10.
Medications: such as NSAIDs, codeine, morphine, contraceptive pills, allopurinol, erythromycin, ethambutol, and pyrazinamide.
Therefore, there are many potential causes of itching; diagnosing the underlying disease clinically requires consideration of other symptoms and may necessitate certain examinations.
It is not possible to determine the presence of hematological or malignant diseases solely based on the symptom of itching.
It is recommended that you discuss this matter in detail with your family physician or consult a dermatology outpatient clinic at a regional hospital for further evaluation.

Reply Date: 2020/05/20

More Info

Unexplained skin itching can be a perplexing and frustrating experience, especially when it occurs sporadically and without any visible skin changes. It is important to understand that itching, or pruritus, can have a variety of causes, ranging from benign to more serious underlying conditions.
In your case, the intermittent itching you described on your knees and hands, which resolves after a short period, may not necessarily indicate a serious health issue. Common causes of localized itching include dry skin, allergic reactions, insect bites, or even contact dermatitis from exposure to irritants or allergens. Since you mentioned that the skin appears normal and the itching resolves on its own, it is less likely to be related to a systemic condition.

However, it is essential to consider other potential causes. For instance, certain skin conditions such as eczema, psoriasis, or hives can cause itching without significant visible changes. Additionally, systemic conditions such as liver disease, kidney disease, or thyroid disorders can also manifest as generalized itching. In your case, since you have had normal blood tests and an abdominal ultrasound, it seems less likely that a serious systemic condition is at play.

Given your concerns about blood and lymphatic diseases, it is crucial to note that while itching can sometimes be a symptom of more serious conditions, it is often not the sole indicator. If you are experiencing other symptoms such as fatigue, unexplained weight loss, night sweats, or changes in appetite, it would be prudent to seek further medical evaluation.
In terms of management, since you have found some relief with topical anti-itch creams, continuing to use these may be beneficial. Additionally, maintaining skin hydration by using moisturizers regularly can help alleviate dryness, which is a common cause of itching. Avoiding known irritants, such as harsh soaps or detergents, and wearing loose-fitting clothing can also help reduce irritation.

If the itching persists or worsens, or if you develop any new symptoms, it is advisable to consult a healthcare professional. They may recommend further testing, such as allergy testing or a skin biopsy, to determine the underlying cause of your symptoms.
In summary, while unexplained skin itching can be concerning, it is often related to benign causes. However, if you have ongoing concerns about your health or if the itching is accompanied by other symptoms, seeking medical advice is always a good course of action. Remember, your health is paramount, and addressing any worries with a healthcare provider can provide peace of mind and appropriate care.

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