Approach to Pruritus

Differential diagnosis

• Obstructive jaundice
  • Primary biliary cirrhosis
  • Head of pancreas tumour
  • Cholangiocarcinoma
• Chronic renal disease
• Haematological
  • Iron deficiency
  • Polycythaemia
• Neoplastic
  • Bronchial carcinoma
  • Hodgkin lymphoma
• Endocrine
  • Hyperthyroidism
  • Hypothyroidism
  • Diabetes
• Infections
  • Scabies infestation
• Drugs
  • Oral contraceptive pill (cholestasis)
  • Opiates
  • Alcohol or drug withdrawal