title: Clinical classification of itch: a position paper of the International Forum for the Study of Itch.
abstract: Chronic itch is a common and distressing symptom that arises from a variety of skin conditions and systemic diseases. Despite this, there is no clinically based classification of pruritic diseases to assist in the diagnosis and cost-effective medical care of patients with pruritus. The proposed classification focuses on clinical signs and distinguishes between diseases with and without primary or secondary skin lesions. Three groups of conditions are proposed: pruritus on diseased (inflamed) skin (group I), pruritus on non-diseased (non-inflamed) skin (group II), and pruritus presenting with severe chronic secondary scratch lesions, such as prurigo nodularis (group III). The next part classifies the underlying diseases according to different categories: dermatological diseases, systemic diseases including diseases of pregnancy and drug-induced pruritus, neurological and psychiatric diseases. In some patients more than one cause may account for pruritus (category "mixed") while in others no underlying disease can be identified (category "others"). This is the first version of a clinical classification worked out by the members of the International Forum for the Study of Itch. It is intended to serve as a diagnostic route for better evaluation of patients with chronic pruritus and aims to improve patients' care.
authors.affiliation: Clinical Neurodermatology, Department of Dermatology, University of Münster, Von-Esmarch-Strasse 58, Münster, Germany. sonja.staender@uni-muenster.de
authors.forename: Sonja
authors.initials: S
authors.lastname: Ständer
authors.forename: Elke
authors.initials: E
authors.lastname: Weisshaar
authors.forename: Thomas
authors.initials: T
authors.lastname: Mettang
authors.forename: Jacek C
authors.initials: JC
authors.lastname: Szepietowski
authors.forename: Earl
authors.initials: E
authors.lastname: Carstens
authors.forename: Akihiko
authors.initials: A
authors.lastname: Ikoma
authors.forename: Nora V
authors.initials: NV
authors.lastname: Bergasa
authors.forename: Uwe
authors.initials: U
authors.lastname: Gieler
authors.forename: Laurent
authors.initials: L
authors.lastname: Misery
authors.forename: Joanna
authors.initials: J
authors.lastname: Wallengren
authors.forename: Ulf
authors.initials: U
authors.lastname: Darsow
authors.forename: Markus
authors.initials: M
authors.lastname: Streit
authors.forename: Dieter
authors.initials: D
authors.lastname: Metze
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Luger
authors.forename: Malcolm W
authors.initials: MW
authors.lastname: Greaves
authors.forename: Martin
authors.initials: M
authors.lastname: Schmelz
authors.forename: Gil
authors.initials: G
authors.lastname: Yosipovitch
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Bernhard
mesh_terms: D002908:Chronic Disease; D006801:Humans; D009422:Nervous System Diseases / Q000175:diagnosis; D011537:Pruritus / Q000145:classification* / Q000209:etiology*; D011602:Psychophysiologic Disorders / Q000175:diagnosis; D012871:Skin Diseases / Q000175:diagnosis