When itching signals more: A case of chronic pruritus leading to cancer diagnosis

JEM reports Pub Date : 2025-06-01 Epub Date: 2025-03-20 DOI:10.1016/j.jemrpt.2025.100163
Christine E. Maloney, William B. Prince
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引用次数: 0

Abstract

Background

Pruritus is a common complaint seen by emergency medicine physicians and carries a broad differential encompassing dermatologic, systemic, neurologic, and psychogenic etiologies.

Case report

A 16-year-old girl presented to the emergency department with two months of pruritus and rash. Prior diagnoses for her symptoms included atopic dermatitis, medication-induced tactile hallucinations, and scabies. Physical examination in the emergency department was notable for a firm supraclavicular lymph node and laboratory studies were notable for systemic inflammation. Biopsy revealed a new diagnosis of classical Hodgkin lymphoma.

Why should an emergency physician be aware of this?

Recognition of refractory chronic pruritus by frontline providers as a presenting symptom of Hodgkin lymphoma can prevent diagnostic delay.
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当瘙痒的信号更多:慢性瘙痒导致癌症诊断的一个案例
背景:瘙痒症是急诊医师常见的主诉,其病因包括皮肤、全身、神经和心理。病例报告一名16岁女孩因两个月的瘙痒和皮疹就诊于急诊科。先前诊断的症状包括特应性皮炎、药物引起的触觉幻觉和疥疮。急诊体检发现锁骨上淋巴结坚固,实验室检查发现全身炎症。活检显示一个新的诊断经典霍奇金淋巴瘤。急诊医生为什么要意识到这一点?一线医生认识到难治性慢性瘙痒是霍奇金淋巴瘤的一种表现症状,可以防止诊断延误。
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来源期刊
JEM reports
JEM reports Emergency Medicine
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