UMMS Affiliation

Department of Medicine, Division of Dermatology

Publication Date


Document Type



Amines; Antidepressive Agents, Tricyclic; Behavior Therapy; Chronic Disease; Cyclohexanecarboxylic Acids; Emollients; Excitatory Amino Acid Antagonists; Histamine Antagonists; Humans; Male; Mianserin; Middle Aged; Pruritus; gamma-Aminobutyric Acid


Dermatology | Skin and Connective Tissue Diseases


This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations. Case: An otherwise healthy 55-year-old man reports that he has been itchy all over for 6 months. The itch interferes with falling asleep and wakes him repeatedly during the night. Initially, there was no rash, but during the past 4 months, itchy nodules and plaques have developed on his back, arms, and legs. Treatment with sedating and nonsedating oral antihistamines and topical glucocorticoids has had no effect. How would you evaluate and manage this case?

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DOI of Published Version



N Engl J Med. 2013 Apr 25;368(17):1625-34. doi: 10.1056/NEJMcp1208814. Link to article on publisher's site

Journal/Book/Conference Title

The New England journal of medicine

Related Resources

Link to Article in PubMed

PubMed ID