SLEEP-DISRUPTING PRURITUS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A CASE REPORT
Arben EMURLAI, Andrej PETROV, Martina GJORGJIEVSKA KAMCEVA
Abstract
The most superficial parts of the skin are the places where the sensation of itching is created and registered through free nerve endings. The sensation of itching is transmitted through myelinated A and unmyelinated C nerve fibers from the skin, through the dorsal roots and dorsal horns of the spinal cord to the thalamus and from there to the cerebral cortex. It is assumed that numerous mediators are involved in its realization, but histamine is considered the leading trigger with a proven effect on itch receptors. Pruritus is an accompanying symptom in many dermatological diseases but also in certain diseases of the internal organs. Clinically, we distinguish two forms of itching: pruritus cum material and pruritus sine material. A 68-year-old female patient, a pensioner, previously worked as a textile worker and was constantly standing for almost 32 years. On examination, she presented due to varicose veins in the lower extremities with a special emphasis on intense itching in the lower legs that persists for a long period of time. She did not use any therapy. On examination, in addition to reticular veins and varicose veins, there is also extremely dry skin on the body, especially on the lower legs, with light desquamation, and in places, there are visible abrasions caused by itching. The patient reports that sometimes the itching disturbs her sleep.
Pages: 60 - 63