[Systemic pruritus: focus on hematological, nephrogenic, and hepatobiliary etiologies].

Systemic pruritus refers to a chronic, generalized sensation of itching in the absence of primary cutaneous lesions. It may represent an important clinical manifestation of underlying internal disease and is particularly associated with hematologic, nephrologic, and hepatobiliary disorders, often displaying characteristic clinical features. In some cases, pruritus precedes the diagnosis of the underlying condition by months or even years and may therefore serve as an early indicator of a hematologic malignancy or cholestatic liver disease. More commonly, however, it occurs concurrently with the diagnosis of the underlying disorder. The onset of systemic pruritus after the diagnosis has been established is frequently therapy-related or may indicate recurrence of the underlying disease. Management primarily focuses on treatment of the underlying condition. In addition, several symptomatic therapeutic approaches are available to alleviate the associated sensory discomfort. A thorough understanding of the pathophysiology and treatment of systemic pruritus is therefore of considerable clinical importance in general medicine, internal medicine, and dermatology.