Case report: Itchy all over

It may be a product of our stressful, modern life or an increasing widespread sensitivity to our environment, but at our walk-in clinic I seem to be encountering a large number of patients who present with rashes which I attribute to “scratch or itch” or “neurodermatitis.” Often, the complaint is not principally a rash, but the itch associated.I just saw another prime example of the phenomenon. A 25-year-old brown-skinned female, recently immigrated and part of a struggling family, reported being “itchy all over” for over three month—and had developed an annoying rash on various parts of her body—for at least one month. Polysporin had not helped and the rash had even bled at times, following scratching.Read: Case report: Spot onA typical area of rash is shown on the picture. Although the location—on the flexural portion of her arm—might suggest eczema, the other areas on her body were so widespread and recent, to suggest otherwise. She was in good health, with no known allergies and taking no medications. She had not had “seasonal” allergies or rashes as a child—just since moving to Canada. The dermatitis was chronically excoriated.I explained the probable cause of the patient’s rash—and sympathized with the itch. I prescribed Elocom cream for judicious use on the worst areas, CeraVe anti-itch cream generally and Rupall as an anti-itch antihistamine. Fortunately, she had a drug plan. Scratching was discouraged.It seems strange that evolution produced “itch” as a sensation related to healing damage or sensitivity to stress or the environment. Keeping track, I was surprised to enumerate many occasions through the day where I personally scratched various body locations which had no apparent rash. I suggest that, as an interesting experiment, others keep track of how often they scratch, where and why.Dr. Robert Dickson is a family physician in Hamilton. This report is based on a real case from Dr. Dickson’s files.

Case report: Itchy all over

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