What causes itching and a burning sensation all over my body?

Question

Hello doctor,

I am experiencing severe, generalized itching with a burning sensation all over my body, which is significantly disturbing my sleep. There is no visible rash or evidence of a fungal infection; however, I have noticed small, blister-like lesions on my toes and between my fingers.

In addition, I have itching and skin changes involving the skin of the testes and penis. The itching is intense and burning in nature and persists even when I am not scratching.

I would like to know the following:

What are the possible causes of these symptoms?
Could this be an infection, an allergic reaction, or another skin condition?
What investigations and treatments would you recommend?

Please advise regarding the diagnosis and appropriate management.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for reaching out and explaining your symptoms in detail.

Based on your description, the most likely diagnosis is scabies, which is a common parasitic skin infestation. Scabies typically causes intense generalized itching that is worse at night and may be associated with burning even without scratching. The involvement of finger webs, spaces between the toes, and genital areas such as the penis and scrotum is very characteristic.

In many patients, there may be very few visible lesions initially, and the itch can feel disproportionate to what is seen on the skin due to a hypersensitivity reaction to the mite. Another possibility is scabies with an exaggerated allergic response, where the immune system reacts strongly, leading to severe itching all over the body, even in areas without obvious lesions. This can also cause sleep disturbance and a persistent burning sensation.

Potential causes include allergic or irritant contact dermatitis caused by new soap or detergent usage, use of antiseptic or excessive bathing, which includes cleaning of the genitals.

It is highly uncommon that contact dermatitis would occur along with finger webs and toes at the same time. Fungal infections are less likely because they are normally seen as having typical characteristics of redness, flaking, and sharp demarcation.

I would suggest scabies as the most probable diagnosis. In order to establish it and continue the treatment, it would be good to see some pictures of the lesions on your finger webs, toes, and genitals if you do not mind sharing them. Also, tell me whether there are any similar cases of itching among the family members and whether the symptom is aggravated at night time. Please inform me about any new soap usage or creams/medication application.

Meanwhile, take tablet Cetirizine 10 mg at bedtime daily and get back with the answers and picture for further treatment. Consult your specialist doctor, discuss with them, and take the medicines with their consent.

I hope this was helpful.

Thank you.