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Since only a small percentage of patients with generalized pruritus respond to antihistamines (H<jats:sub>1<\/jats:sub> receptor antagonists), a variety of itch mediators and mechanisms other than histaminergic signals are considered to be involved in itch for these non\u2010responsive patients. In 2012, we created guidelines for generalized pruritus. Those guidelines have been updated and revised to make some of the definitions, diagnostic terms, and classifications more applicable to daily clinical practice. Cutaneous pruritus as designated in these guidelines is a disease characterized by itch without an observable rash. Generalized pruritus (without skin inflammation) is defined as the presence of itch over a wide area, and not localized to a specific part of the body. This entity includes idiopathic pruritus, pruritus in the elderly, symptomatic pruritus, pregnancy\u2010associated pruritus, drug\u2010induced pruritus, and psychogenic pruritus. Localized pruritus (without skin inflammation) represents fixed itch localized to a specific part of the body, and includes anogenital pruritus, scalp pruritus, notalgia paresthetica, and brachioradial pruritus. These guidelines outline the current concepts and specify the diagnostic methods\/treatments for cutaneous pruritus.<\/jats:p>","DOI":"10.1111\/1346-8138.16066","type":"journal-article","created":{"date-parts":[[2021,7,21]],"date-time":"2021-07-21T06:11:20Z","timestamp":1626847880000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["2020 guidelines for the diagnosis and treatment of cutaneous pruritus"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2244-6332","authenticated-orcid":false,"given":"Takahiro","family":"Satoh","sequence":"first","affiliation":[{"name":"Department of Dermatology National Defense Medical College Tokorozawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5773-9485","authenticated-orcid":false,"given":"Hiroo","family":"Yokozeki","sequence":"additional","affiliation":[{"name":"Department of Dermatology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0450-1377","authenticated-orcid":false,"given":"Hiroyuki","family":"Murota","sequence":"additional","affiliation":[{"name":"Department of Dermatology School of Medical Sciences Nagasaki University Nagasaki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiki","family":"Tokura","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Kabashima","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kyoto University Graduate School of Medicine Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0644-0504","authenticated-orcid":false,"given":"Kenji","family":"Takamori","sequence":"additional","affiliation":[{"name":"Juntendo Itch Research Center Institute for Environmental and Gender\u2010specific Medicine Juntendo University Graduate School of Medicine Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuo","family":"Shiohara","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kyorin University School of Medicine Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eishin","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Dermatology Faculty of Medicine Shimane University Izumo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Setsuya","family":"Aiba","sequence":"additional","affiliation":[{"name":"Department of Dermatology Tohoku University School of Medicine Sendai Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yumi","family":"Aoyama","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kawasaki Medical School Kurashiki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6779-5598","authenticated-orcid":false,"given":"Takashi","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Dermatology National Defense Medical College Tokorozawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ichiro","family":"Katayama","sequence":"additional","affiliation":[{"name":"Department of Dermatology Course of Integrated Medicine Graduate School of Medicine Osaka University Suita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,7,20]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2004.06058.x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-0641"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2004.01967.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2005.02607.x"},{"key":"e_1_2_11_6_1","first-page":"1842","article-title":"Evaluation of labor productivity and study of remedial effect of histamine H1 antagonists in patients with skin diseases accompanied by itching","volume":"29","author":"Murota H","year":"2009","journal-title":"Prog Med"},{"key":"e_1_2_11_7_1","first-page":"107","article-title":"Skin disease in Lambeth. 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