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Dr. Shahz
Dr. Shahz, Dermatologist
Category: Dermatology
Satisfied Customers: 243
Experience:  MBBS, MCPS, MD
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extreme itching sensation, skin crawling, almost needle pricking

Resolved Question:

extreme itching sensation, skin crawling, almost needle pricking from the "inside" nor physical signs on skin, occurs mostly on legs and arms. no common threads to what starts the onset. ruled out anxiety. no common denominators.

diagnosed with mixed connective tissue disorder three months ago. taking plaquenil for it, along with vistaril for anxiety when needed. and ambien to sleep at night.

need direction to help with skin sensation. hot water baths give relief, along with tanning at some times. tanning does not make it worse. taking antihystamines (benadryl and prescription) but seems to offer little relief
Submitted: 4 years ago.
Category: Dermatology
Expert:  Dr. Shahz replied 4 years ago.

Dr.shahz : Your satisfaction is my obligation,please ACCEPT only if you are satisfied,a positive feedback would be highly appreciated.
Dr.shahz : Would you tell are there any hives like lesions or bumps?
Dr.shahz : Generalised itch with no physical signs can be associated with some systemic diseases like Thyroid disorders,Diabetes,kidney disorders and some liver dysfunctions.
Dr.shahz : So I would suggest to do the following blood function tests like thyroid function tests,kidney function trst
Dr.shahz : Liver function test,complete function test,
Dr.shahz : It will be easy to reach to a conclusion after you clear off these condition on the basis of these tests.
Dr.shahz : One possibility would be Urticaria of unknown cause but the lesions would be raised and would be present for atleast 24 hours.
Dr.shahz : So I would suggest to do these blood tests to rule out these conditions.
Dr.shahz : In the mean time I would suggest to use Tablet.Allegan 180 mg once a day for 3 weeks each morning
Dr.shahz : Tablet- Tagamet 300mg once a day for 1 month.
Dr.shahz : Tablet-Zyrtec once a day before going to bed for atleast 2 weeks.
Dr.shahz : If you feel that the conversation was helpful then you can click the green the ACCEPT button to credit your expert.
Customer: We had liver test done. Completely normal. What about the possibility that the body is creating its own opiate. Was looking at the benefit of getting a prescription for Ondansetron,.
Dr.shahz : As I have said earlier that an autoimmune cause can't be exluded
Dr.shahz : And ondansetron is an anti sickness medication do it would not help at all.
Dr.shahz : 0
Dr.shahz : I would be happy to answer any more queries.
Dr.shahz : If you think that the conversation was helpful then please don't forget to click on the green ACCEPT button,a positive feedback would be appreciated,
Dr.shahz : Thanks

only researched the anti sickness medication because it suppresses Serotonin levels. It certainly seems like this is related to paresthesia, but no one seems to be offering any real help, her GP, her Rheumatologists all think it must be nothing of any magnitude, but when it starts she simply goes crazy. itching seems to make it worse. we use benadryl creams, and pills, and have tried calming lotions, cortisone, heat pads, ice pack. She is to the point she takes pain meds along with the benadryl just to "knock her out" so she can rest. And again, no physical signs on the skin,

Dr.shahz : Thanks for your input
Dr.shahz : I would suggest not to use the topical anti allergics as it can aggravate the situation.
Dr.shahz : I would advise to start using Tablet Hydroxzine 25 mg at night and Tablet Allera 180mg in the morning.
Dr.shahz : I advised some of my patients to use Tablet Gabapenten starting from 100mg a day
Dr.shahz : Its an anti epileptic medication but can be used in chronic itch and PRURIGO if the blood tests are negative for any systemic involvement.
Dr.shahz : It's a prescription only medication so you need to see your Family doctor for that matter.
Dr.shahz : I would suggest not to use a very hit water bath or shower and please use a good quality moisturising lotion twice a day and after shower to lock in the moisture.
Dr.shahz : I just want you to do a blood glucose test and thyroid and kidney function tests just to rule out their involvement.
Dr.shahz : And a full blood count to know the blood cells picture,and in the meantime the patient can use these above described medications.
Dr.shahz : Do you have any more questions?
Dr.shahz : I hope this conversation was helpful to you,please don't forget to click on the green ACCEPT button if you are happy with the answers.
Dr.shahz : You can also discuss the use of Tricyclic antidepressants like Amitriptylline with you doctor They can also be of help sometimes.
Dr.shahz : These are the best possible options which are in practice for pruritus especially if all the blood tests are normal. A person should drink plenty of water to keep the ski
Dr.shahz : Skin hydrated.
Dr.shahz : Cold wet dressing and avoiding hit showers can add to the medicinal therapy.
Dr.shahz : I hope this information was of help to you,would be happy to any more queries.
Dr.shahz : All the best.
Dr.shahz : Just a thought,also avoid rough clothings or fabrics,overheating and alcohol spices and caffein.
Dr.shahz : Keep the nails short and clean if there is an intense urge to scratch then rub it with the palm of your hands ci the nails can break the skin and would invite bacteria to cause infections.

Thanks, XXXXX XXXXX try to see if this helps her, we certainly need to find some relief.

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