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Itchy skin disease

Pruritus case challenge 2

Case 2 presented with a 12-month history of increasing generalisd pruritus. The patient has a chronic cough and reports feeling lethargic and generally unwell. Bilateral axillary lymphadenopathy was present and widespread excoriations have resulted in erosions and scars.

Which of the following investigations should be performed as a minimum? #! Full blood count #! Liver function tests #! Renal function tests #! Thyroid function tests #! Chest X-ray Explanation: Unfortunately although blood tests were within normal limits chest X-ray showed mediastinal lymphadenopathy and a diagnosis of non-Hodgkin’s lymphoma was made on axillary lymph node biopsy. The patient’s itch was eliminated by chemotherapy but returned on relapse of the lymphoma. There was some improvement with topical antipruritic lotions and paroxetine, but severe pruritus persisted until death.