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Hematologic, bile duct malignancies risks for chronic pruritus on nondiseased skin
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Patients with chronic pruritus without concomitant skin changes were at risk for having undiagnosed hematologic or bile duct malignancies, according to recent study results.
Researchers conducted a population-based cohort study of 8,744 patients with chronic pruritus (itch lasting for equal to or greater than 6 weeks; mean age, 61.19 years; 62.4% women) without concomitant skin findings and 31,580 patients without chronic pruritus matched on sex, age and practice. Hazard ratios of incidence malignancy and malignancy subtypes were primary outcomes.
A higher prevalence of renal disease, liver disease, thyroid disease, diabetes, depression and anxiety was reported in the patients in the chronic pruritus cohort compared with the non-pruritus cohort before the study enrollment date. The patients with chronic pruritus had a HR of 1.14 (95% CI, 0.98-1.33) for incident malignancy when fully adjusted for sex, age, liver disease, renal disease, diabetes and smoking. Incident hematologic malignancy had a fully adjusted (age and sex) HR of 2.02 (95% CI, 1.48-2.75) and incident bile duct malignancy had a fully adjusted (including age) HR of 3.73 (95% CI, 1.55-8.97) in patients with chronic pruritus.
Hematologic malignancy and cholangiocarcinoma incidence in patients with chronic pruritus was 0.0016 and 0.0003 person-year, compared with 0.0008 and 0.0001 person-year for those without chronic pruritus, respectively.
The risk of death in patients with chronic pruritis had an unadjusted HR of 1.27 (95% CI, 1.17-1.37); however, in the fully adjusted model, death risk was not statistically significant (HR=1.13; 95% CI, 0.96-1.33).
“Our study suggests that chronic pruritus without coded concomitant skin changes is not an indicator of increased risk of an undetected malignancy overall, but may be an indicator of increased risk of undetected hematologic and bile duct malignancies,” the researchers concluded.
“Broad screening for malignancy in patients with chronic pruritus without concomitant skin findings and without additional signs and symptoms of malignancy is unnecessary.”
Disclosure: The researchers report no relevant financial disclosures.
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