By Gary M. White, MD
Aquagenic pruritus (AP) is the sensation of intense itching upon exposure to water.
- Itching is of course very common in patients with atopic dermatitis. For may of these patients, the itch is provoked by sweating or bathing [Acta Derm Venereol. 2009;89(4):379-83].
- A percentage of cases of AP are associated with polycythemia vera (PCV). The PCV may be caused by a variety of factors, e.g., administration of testosterone myelofibrosis extra.
- AP has also been reported in association with myelofibrosis, malignancy, medications (bupropion, antimalarials), and lactose intolerance.
Bathing pruritus is a subset of AP and is defined by pruritus with contact from the bath water. Various factors may cause BP including the water temperature, physical characteristic/ionic content and the Ph of the water, the soap used in bathing, sponging and toweling afterwards. As noted above, bathing pruritus is common in patients with atopic dermatitis.
If the skin is dry, routine moisturising may help. See dry skin hand out.
Oral antihistamines may be tried. Reduction of the PCV (e.g., phlebotomy) can improve the symptoms. Other reported treatments have included naltrexone, NB-UVB, montelukast, and propranolol.
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