Etiopathogenesis and Current Management of Oncogenic Pruritus - A Narrative Review

Abstract

Oncogenic pruritus or malignancy associated pruritus is an emerging cause of systemic pruritus in patients with malignancies. It is a debilitating condition and worsens the patient's quality of life, often interfering with their palliative care. Oncogenic pruritus can arise de-novo in such patients due to release of pruritogens and other inflammatory mediators from tumour cells into blood stream, or it may present as a component of paraneoplastic syndrome. A detailed history and clinical examination are necessary to rule out other causes of systemic pruritus. Objective evaluation of itch is recommended using various scales to evaluate the treatment response and assessing its severity. There is lack of clinical trials concerning the management of oncogenic pruritus and most information is derived from sporadic case reports. Despite being an important and emerging cause of pruritus during malignancy, this diagnosis is often missed and remains under-reported due to lack of awareness about this entity. This narrative review highlights the current understanding of this condition focusing on its causes, pathogenesis, diagnosis, and management, along with newer investigational drugs. These authors hope that the present review will generate awareness about this condition among treating physicians and enable its early diagnosis and appropriate management.

Keywords: Malignancy associated pruritus; management; oncogenic pruritus; pathogenesis.