Psychogenic pruritis is a psychological condition that causes the manifestation of an itch as the main symptom or the worsening of an existing itch.
Psychogenic pruritis (PP) is a condition that has a psychological or psychiatric cause and manifests as an itch. It may also be referred to as functional itch, psychogenic itch, or functional itch disorder  . It is one of the possible sources of chronic itch, which is defined as an itch that lasts for at least 6 weeks.
Pruritis occurs commonly among the general population, but only a minority of cases, about 10%, need treatment. Although itching may be caused by various etiologies, it may lead to significant psychological and psychiatric distress, including thoughts of suicide. It involves the skin and mucosa, and can be described as an uncomfortable sensation that may be relieved by scratching. There may be associated cutaneous sensations occurring simultaneously with the itch, such as burning, tingling or pain. Pruritis can also be caused by neurological problems stemming from nerve cell damage  . This may have an atypical presentation, that is, accompanied by sensations such as paresthesia .
PP may prove a challenge to diagnose because it is often presumed to be dermatological in origin. Thus patients suffering from PP are more likely to present to dermatologists initially. Furthermore, misdiagnosis may be partly due to a poorly defined definition and criteria for the condition. Moreover, before PP may be proposed, there are systemic diseases that cause pruritis and that should be first considered and ruled out. It is further suggested that not only can psychological factors induce the occurrence of an itch, they can also exacerbate or prolong an already existing one. Although PP may be diagnosed by clinicians, patients are rarely referred for psychiatric evaluation and intervention.
In literature, the incidence of idiopathic itch in individuals with a psychiatric history is reportedly as high as 42%  . Pruritis in the presence of psychiatric disease is more likely to involve the face and scalp than pruritis from other causes .
The diagnostic process for psychogenic pruritis entails the acquisition of a medical history, followed by a physical examination. Causes of pruritis related to medication use (delineated in the patient drug history) or systemic disease should be investigated, thus a systemic review is necessary  . Dermatological conditions should also be excluded by thorough examination of the skin. PP may also be associated to other conditions, neuropathic in nature, that are not yet well-known or understood .
Investigative blood tests that may be requested include:
If a diagnosis is not found upon the first visit, patients should be reevaluated on subsequent visits.