Alcohol (OH) and the Skin – Pruritus (Itch) (For professionals)

Dr Christophe HSU – dermatologist. Geneva, Switzerland

Pruritus

• It may appear up to 2 years before the onset of cirrhosis
• 40% of alcohol abusers with liver disease are estimated to have severe pruritus
• generalized but with predilection to extensor extremities, upper trunk, palms and soles
• chemical mediators (Bile acids) are thought to directly depolarize nerve endings or release pruritogenes (histamine).
• Treatment with bile acid-binding resins (cholestyramine) relieves the pruritus in 80% of cases, but malabsorption of vitamins A, D, E and K. Also methyltestosterone or norethandrolone, UVA and UVB photoherapy. Phenobarbital (3mg/KG), intravenous albumin, extracorporeal photophoresis, diets rich in polyunsaturated acids.
• Poor correlation with bile-levels/pruritus though.

Contributors:

Dr Christophe HSU – dermatologist. Geneva, Switzerland

Bibliography: Dermatologie et Infections Sexuellement Transmissibles, 4th Edition