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Updated: May 31, 2026

Cheek Injection Model for Simultaneous Measurement of Pain and Itch-related Behaviors
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A diagnostic approach to pruritus.

Brian V Reamy1, Christopher W Bunt, Stacy Fletcher

  • 1Uniformed Services University of the Health Sciences, Bethesda, MD 21037, USA. breamy@usuhs.mil

American Family Physician
|July 20, 2011
PubMed
Summary

Generalized pruritus without a skin cause often signals underlying systemic disease. Evaluation should include blood tests and assessment for conditions like thyroid disorders, lymphoma, and diabetes.

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Area of Science:

  • Dermatology
  • Internal Medicine

Background:

  • Pruritus (itching) can stem from skin conditions or hidden systemic diseases.
  • 14-24% of patients with generalized pruritus and no apparent skin cause have a systemic origin.

Purpose of the Study:

  • To outline diagnostic approaches for generalized pruritus.
  • To identify systemic etiologies associated with pruritus.

Main Methods:

  • Review of systems focusing on potential systemic causes.
  • Laboratory tests including complete blood count, thyroid-stimulating hormone, glucose, liver function, kidney function.
  • Imaging like chest radiography if lymphoma is suspected.

Main Results:

  • Systemic diseases like thyroid disorders, lymphoma, kidney/liver disease, and diabetes are common causes of pruritus.
  • Hodgkin lymphoma is strongly linked to pruritus (up to 30% of patients).
  • Wheal and flare response suggests histamine involvement in urticaria/allergic dermatitis.

Conclusions:

  • Systemic evaluation is crucial for pruritus without a clear dermatologic cause.
  • Specific laboratory and imaging tests aid in diagnosing underlying conditions.
  • Antihistamines are beneficial for histamine-mediated pruritus.

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