Clinical Pearls

The Itch to Cure: Managing Pruritis

Lindsay Haines, MD, and Niharika Ganta, MD MPH

Background

When severe, pruritis—ie, itch—results in significant distress and poor quality of life.¹ Pruritis is poorly understood and can be difficult to manage. Unfortunately, the “go-to” remedies often are inadequate and ineffective when pruritus is chronic and the result of an underlying chronic disease. Limited data exists on rates of pruritis in hospice and palliative care patients. However, one study reported pruritus in 35% of patients and xerosis (ie, dry skin) in 78% of patients—86% of which had cancer—admitted to an inpatient palliative care unit.² Generally, chronic pruritus more often is associated with chronic kidney disease (CKD), cholestasis, and systemic opiate use, but rates of pruritus among hospice and palliative care patients with these diagnoses in particular have not been studied.³