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Aquagenic pruritus

Intense itching or stinging without any visible skin changes, triggered within minutes of contact with water.

Atopic dermatitis

A chronic inflammatory skin disease where intense pruritus is the defining symptom, leading to the 'itch-scratch' cycle and characteristic eczematous lesions.

Brachoradial pruritus

A localized neuropathic itch on the dorsolateral arms, often associated with sun exposure and cervical spine disease.

CTCL

Intractable, severe pruritus is a hallmark symptom of cutaneous T-cell lymphoma, particularly in the erythrodermic stage (Sezary syndrome).

Fiberglass dermatitis

An irritant contact dermatitis from exposure to fiberglass spicules, causing intense itching and papules.

HIV

Generalized pruritus is a common symptom in HIV, and can be due to xerosis, eosinophilic folliculitis, or other HIV-associated dermatoses.

Hepatic impariment

Cholestatic liver disease can cause severe, generalized pruritus due to the accumulation of bile salts, which is often worse at night.

Hepatitis C

Chronic hepatitis C infection is frequently associated with generalized pruritus, separate from pruritus caused by liver failure.

Hodgkin's disease

Severe, paraneoplastic pruritus is a classic systemic symptom of Hodgkin's lymphoma, sometimes preceding the diagnosis by years.

Iron deficiency

Can be a cause of generalized pruritus, which resolves with iron supplementation.

Lichen simplex chronicus

A localized, thickened plaque of skin that results from, rather than causes, a cycle of chronic, localized itching and scratching.

Mastocytosis

Pruritus and flushing are caused by the release of histamine from an excess of mast cells in the skin.

Meralgia paresthetica

A neuropathic condition of burning and itching on the anterolateral thigh due to compression of the lateral femoral cutaneous nerve.

Nodular prurigo

A condition characterized by multiple, intensely itchy, firm nodules that are created and perpetuated by chronic scratching.

Non Hodgkin's lymphoma

Generalized pruritus can be a paraneoplastic sign of various non-Hodgkin's lymphomas, although less commonly than in Hodgkin's disease.

Notalgia paresthetica

A common neuropathic condition causing a localized patch of intense itching on the upper back, typically just medial to the scapula.

Pediculosis

Infestation with lice (head, body, or pubic) causes intense itching due to a hypersensitivity reaction to louse saliva.

Polycythemia rubra vera

A myeloproliferative disorder that characteristically causes aquagenic pruritus (itching after contact with water).

Postherpetic neuralgia

While typically causing pain, this complication of shingles can also manifest as a persistent, localized, neuropathic itch in the affected dermatome.

Pregnancy

Intense pruritus, especially in the third trimester, can be a sign of cholestasis of pregnancy, requiring medical evaluation.

Psychogenic pruritus

A diagnosis of exclusion for generalized itching related to a primary psychiatric condition, often with linear excoriations from scratching.

Renal impairment

Uremic pruritus is a common and distressing symptom in patients with end-stage renal disease, causing severe, generalized itching.

Scabies

A parasitic infestation causing severe, generalized pruritus that is characteristically worse at night, due to a hypersensitivity reaction to the mite.

Thyroid disease

Both hyperthyroidism (due to increased blood flow) and hypothyroidism (due to severe dry skin) can cause generalized pruritus.

Urticaria

Hives are defined by the presence of transient, edematous, intensely pruritic wheals.

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