Cholestatic pruritus: a knowledge update

This review is focused on updating knowledge about cholestatic pruritus. It summarizes clinical-epidemiological characteristics, pathophysiology, diagnostic approach, and evidence-based therapeutic recommendations regarding this form of pruritus. Pruritus is a frequent symptom that accompanies several liver diseases, particularly cholestatic ones. The symptom may be mild and tolerable, but it can also dramatically reduce the quality of life. Although the exact pathophysiology of this form of pruritus remains unclear, current evidence supports a mixed origin. It is extremely important for dermatologists to have knowledge about cholestatic pruritus since they are usually the first physicians to be sought by the patient when they experience the symptom. In the absence of specific dermatological alterations, cholestasis must always be considered as a possible cause of pruritus. In addition to allowing an adequate diagnosis, a better pathophysiological understanding of hepatic pruritus provides the identification of new therapeutic targets and, consequently, optimization of the approach in patients with this condition. (C) 2022 Published by Elsevier Espana, S.L.U. on behalf of Sociedade Brasileira de Dermatologia.

Automated summary

This review focuses on updating knowledge about cholestatic pruritus, including its clinical-epidemiological characteristics, pathophysiology, diagnostic approach, and evidence-based therapeutic recommendations. It emphasizes the importance for dermatologists to have knowledge about cholestatic pruritus, as they are usually the first physicians to be approached by patients experiencing this symptom. Understanding the pathophysiology of hepatic pruritus can help identify new therapeutic targets and optimize treatment approaches.