Are there any other non-serious causes of generalised itching?
Scabies some of the lesions may be very subtle but the classic history is that other members of the family have similar symptoms. Physical examination occasionally reveals burrows, although how many GPs actually have time to dig the mite out and look at it under the microscope is uncertain. Working with fibreglass can cause an irritant dermatitis with occasional fibreglass particles seen on skin scrapings. Aquagenic pruritis is associated with itching after a bath or a shower. The temperature of the water does not matter. There are no skin manifestations and the symptoms usually abate within the hour. There is often a positive family history. Let’s suppose that all investigations are normal, the patient looks well and there are no skin changes. Now what do I do? Have you considered psychogenic pruritus? This is a diagnosis of exclusion but may sometimes need a psychiatric referral. Anxiety and depression can cause generalised itching and a feeling of something ‘crawling under the ski
