ITCH

Chronic Pruritus

Also known as Inflammatory Itch, it is a primary symptom of many chronic inflammatory conditions.

Increased understanding of the neuroimmunology of pruritus provides support for MRGPRX2 as a key receptor driving the release of a wide variety of itch-causing cytokines that are highly unregulated in inflammatory conditions. Treatment of pruritus is challenging, and currently, only limited, short-term, symptomatic relief is available to patients.

My painful and maddening battle with chronic itching began in 2014, before I was diagnosed with C.A.R.P.A.

It started as a minor irritation on my leg, which I dismissed as an insect bite; however, within a few weeks, it had turned into relentless, full-body torment. The unbearable itching led to constant scratching, leaving my skin raw, bleeding, and inflamed, which caused intense pain and distress.

Despite the best efforts of my doctor, my entire body itched nonstop, day and night, for over a year. During that time, she sent me to numerous wards and hospitals, to the point where it felt like I spent more time in medical facilities than at home.

I underwent a series of diagnostic procedures, including several MRIs, lumbar punctures, biopsies, and many blood tests. I was also prescribed various medications, ranging from topical creams to oral medications, injections, and light therapy (phototherapy). Unfortunately, none offered the relief I desperately needed, and some even triggered life-threatening reactions.

Since nothing relieved the itching, I was referred to different specialists. Some of these doctors kept bombarding me with all kinds of medications, including corticosteroids, antihistamines, opioids, and drugs that, to this day, I do not understand why the doctor thought it was going to help my condition, like Levomepromazine, Nozinan, which worsened my condition instead of helping.

Since I had not yet received the CARPA diagnosis, I didn't realize how all these medications were actually putting my life at risk rather than helping.

My hair was falling out in clumps, I gained a lot of weight, and nothing seemed effective. The lack of answers and a clear diagnosis heightened my anxieties, making me feel as if I were about to die or lose my sanity. The only antihistamine that offered some relief was an old one—Tavegil. I initially tried it in oral tablet form, but I had a reaction, so I had to learn how to inject myself intramuscularly. However, this medication also caused adverse effects, including severe fatigue, malaise, dry mouth, and rashes. Ultimately, I decided to stop all these medications.

As of 2025, I still suffer from pruritus; however, now identified as one of the symptoms of C.A.R.P.A., I have learned to avoid some of its triggers. Although it is no longer constant or as widespread, and it mainly appears at night, it still disrupts my sleep and overall quality of life.

Pruritus is defined as itching that lasts for six weeks or more and can arise from various factors.

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After my C.A.R.P.A. diagnosis, I realized that my allergic reactions were actually triggered by the same medications used to treat my previously undiagnosed conditions.

This situation created a catch-22: medications meant to cure my ailment unintentionally worsened the very conditions they aimed to cure, thereby reducing my resources of treatments and medications I need, which further decreases my quality of life.

Formication (the sensation of insects crawling on and under the skin)

This symptom was a physically and mentally draining ordeal, with formication severely affecting my sleep, eating habits, mental health, and concentration. Certain medications, including steroids, ciprofloxacin, ketoconazole, amantadine, and atypical antipsychotics, can cause formication as a side effect.

These persistent symptoms need a comprehensive investigation into their root causes, which might go beyond C.A.R.P.A. Without help from the healthcare system, my symptoms will stay an agonizing mystery I have to endure.