Aquagenic pruritus

Aquagenic pruritus is a skin disease characterized by the development of severe, intense, prickling-like epidermal itching that is without observable skin lesions and that is evoked by contact with water.^{[1]:401[2]:56}

Presentation

Symptoms may be felt immediately after contact with water or humid air and can persist for an hour or longer. Other triggers may be sweat, blowing air, temperature differences, changing clothes, contact with synthetic fibers, and lying down to try to sleep. This condition may persist for years.

Aquagenic pruritus seems to appear equally in both genders regardless of age and among people with varying skin tones. It is sometimes a symptom of primary polycythemia or polycythemia vera. Strictly speaking, Aquagenic pruritus is not a discrete disease but a cluster of symptoms. In some families, a tendency toward Aquagenic Pruritus appears to be hereditary. Very little research has been done on this condition, and there is much to be learned.

This disease is not to be taken lightly since the intensity of the itch impedes normal activities, limits bathing, and very commonly leads to severe depression. People have been known to suffer alone with this condition for years because family members and doctors did not believe there was a physical cause to the invisible symptoms. Upon receiving a diagnosis of aquagenic pruritus, many people express relief that the condition has been validated, and they are not "going crazy."^{[citation needed]}

Etymology

The name is derived from Latin: Aquagenic, meaning water-induced, and Pruritus, meaning itch.

Treatment

Treatments can include applying capsaicin cream on the affected areas, and filtered Ultraviolet-B Phototherapy in a hospital or health clinic, often using a vertical light cubicle in which the patient stands for the exposure duration. Some people utilize tanning beds to accomplish such treatment, but skin cancer can become a concern for frequent tanning due to the broader UV spectrum of the beds. Some people find relief from a using a TENS unit.

Liberal applications of baby oil before or after bathing, or lanolin-free Aqueous cream, an emollient, immediately after drying off from a bath or shower can help to reduce the symptoms of the condition.

Since pruritus is sometimes believed to be a result of histamine, H1 and H2 blockers such as Claritin, Doxepin or Cimetidine may be helpful. Claritin has been found helpful for mild cases where as Doxepin has been found helpful in more severe cases.

Some sufferers control the itch by turning the shower water to hot for the last 5 minutes, and/or using heatpads or hairdryers on their skin immediately after showering. However, others find that excessive heat during bathing can actually worsen the pruritus, and limit the water temperature to tepid. The use of cotton clothes and bedding can prevent itch or provide relief to some sufferers.

Use of naltrexone has been described.^[3]

See also

• Aquadynia
• Aquagenic urticaria
• Pruritus

Notes

1. ^ Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0071380760.
2. ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0721629210.
3. ^ Ingber S, Cohen PD (October 2005). "Successful treatment of refractory aquagenic pruritus with naltrexone". J Cutan Med Surg 9 (5): 215–6. doi:10.1007/s10227-005-0144-x. PMID 16502200. 

References

• Steinman H, Greaves M (1985). "Aquagenic pruritus.". J Am Acad Dermatol 13 (1): 91–6. doi:10.1016/S0190-9622(85)70149-1. PMID 2411768. 

External links

Personal experiences of sufferers and helpful suggestions may be found here