Pruritus DDx

Pruritus – Differential Diagnosis

Common causes

• Dry skin
• Atopic dermatitis
• Contact dermatitis
• Scabies
• Urticaria
• Lichen simplex chronicus
• Lichen planus
• Psychological

Must Not Miss

• Cholestasis
• Obstetric cholestasis
• Malignancy
  • Lymphoma
  • Leukaemia
• Chronic Renal failure
• HIV

Easily missed

• Medication
• Thyroid disorders
• Iron deficiency anaemia
• Polycythaemia

Red flags

• Abdominal pain & jaundice
• Abdominal/liver mass
• Systemic symptoms (fever, weight loss, fatigue, night sweats)
• Generalised Lymphadenopathy

Investigations to consider

• FBC, CRP/ESR, blood film
• U&Es, LFTs, TFTs
• Ferritin
• Anti- mitochondrial antibody
• Immunoglobulin’s & electrophoresis
• HIV screen
• CXR
• USS (abdomen)
• Liver biopsy