Pruritus is a very frequently seen cutaneous symptom in current dermatological practice. It exerts a significant impact on the overall quality of life of a person. The current consensus article aims at describing clinical views of expert dermatologists, regarding various aspects of pruritus including classification, pathophysiology, diagnosis and appropriate management. A literature search was performed using the databases PubMed and Google Scholar. Relevant articles were identified using keywords like 'pruritus', 'antihistamine' and 'itch'. After screening, 46 relevant articles were identified and included in the document. Effective diagnosis of pruritus includes a comprehensive patient history and physical examination for determining whether pruritus is due to a dermatologic disorder or an underlying systemic disease. This could be followed by basic investigations and subsequent suitable therapy approaches. General care measures are essential for every patient with pruritus.
Various topical therapies used for pruritus include local anaesthetics, pramoxine, capsaicin, calcineurin inhibitors, menthol, camphor, zinc, doxepin, corticosteroids and palmitoyl-ethanol-amine. With respect to systemic therapies, oral antihistamines (e.g., hydroxyzine) are generally the first line of treatment for pruritus. The other systemic therapies include gabapentin and pregabalin, tricyclic antidepressants, doxepin, mirtazapine, naltrexone, cyclosporine and ultraviolet (UV) phototherapy. The current manuscript provides a collation of evidence-based literature and clinical insights of the expert dermatologists.