{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T06:59:59Z","timestamp":1760425199930,"version":"3.40.4"},"reference-count":20,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Pruritus is a major symptom of primary biliary cirrhosis, cholestatic autoimmune disease which affects mostly middle-age women. Often, it can be severe and refractory to multiple treatments, and mostly affecting the patient\u2019s health-related quality of life. Intense pruritus can be itself an indication to liver transplantation, in extreme cases leading to suicide. Its physiopathology has not yet been fully elucidated, but recent studies added the elevation of autotaxin and lysophosphatidic acid to the group of classic mechanisms already linked to cholestatic pruritus. In this case report we illustrate how ultraviolet B phototherapy appears to successfully control severe pruritus and contribute to the healing of pruritic skin lesions caused by intense scratching. There is limited medical literature concerning this therapeutic approach on cholestatic pruritus, but we hope that further randomised controlled trials will successfully establish it as an effective treatment in the near future.<\/jats:p>","DOI":"10.1136\/bcr-2013-200634","type":"journal-article","created":{"date-parts":[[2013,11,14]],"date-time":"2013-11-14T11:57:56Z","timestamp":1384430276000},"page":"bcr2013200634","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Refractory pruritus in primary biliary cirrhosis"],"prefix":"10.1136","volume":"2013","author":[{"given":"Nuno Cercas","family":"Pinheiro","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui Tato","family":"Marinho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Ramalho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"Velosa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,11,14]]},"reference":[{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.1","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.cld.2008.02.013","article-title":"Pruritus in primary biliary cirrhosis: pathogenesis and therapy","volume":"2013","author":"Bergasa","year":"2008","journal-title":"Clin Liver Dis"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.2","doi-asserted-by":"crossref","first-page":"34","DOI":"10.2340\/00015555-0350","article-title":"Itch in primary biliary cirrhosis: a patient's perspective","volume":"2013","author":"Rishe","year":"2008","journal-title":"Acta Derm Venereol"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.3","first-page":"505","article-title":"Primary biliary cirrhosis in Asians: less common than in Europeans, but just as depressing","volume":"2013","author":"Farrell","year":"2008","journal-title":"J Gastroenterol Hepatol"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.4","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1002\/hep.20276","article-title":"Quality of life in patients with primary biliary cirrhosis","volume":"2013","author":"Poupon","year":"2004","journal-title":"Hepatology"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.5","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1016\/j.jhep.2007.01.036","article-title":"Depression in patients with primary biliary cirrhosis and primary sclerosing cholangitis","volume":"2013","author":"Van","year":"2007","journal-title":"J Hepatol"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.6","first-page":"237","article-title":"EASL clinical practice guidelines: management of cholestatic liver diseases","volume":"2013","author":"Beuers","year":"2009","journal-title":"J Hepatol"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.7","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1002\/hep.22906","article-title":"AASLD practice guidelines: primary biliary cirrhosis","volume":"2013","author":"Lindor","year":"2009","journal-title":"Hepatology"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.8","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.cld.2012.11.006","article-title":"Advances in pathogenesis and treatment of pruritus","volume":"2013","author":"Bolier","year":"2013","journal-title":"Clin Liver Dis"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.9","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1007\/s00105-011-2321-8","article-title":"Cholestatic pruritus: new insights into pathophysiology and current treatment","volume":"2013","author":"Kremer","year":"2012","journal-title":"Hautarzt"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.10","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.clinre.2010.10.007","article-title":"Pathophysiology and current management of pruritus in liver disease","volume":"2013","author":"Kremer","year":"2011","journal-title":"Clin Res Hepatol Gastroenterol"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.11","doi-asserted-by":"crossref","first-page":"2163","DOI":"10.2165\/00003495-200868150-00006","article-title":"Pathogenesis and treatment of pruritus in cholestasis","volume":"2013","author":"Kremer","year":"2008","journal-title":"Drugs"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.12","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/S1542-3565(03)00140-X","article-title":"Studying pruritus in the 21st century","volume":"2013","author":"Bergasa","year":"2003","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.13","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1053\/j.gastro.2010.05.009","article-title":"Lysophosphatidic acid is a potential mediator of cholestatic pruritus","volume":"2013","author":"Kremer","year":"2010","journal-title":"Gastroenterology"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.14","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1002\/hep.25748","article-title":"Serum autotaxin is increased in pruritus of cholestasis, but not of other origin, and responds to therapeutic interventions","volume":"2013","author":"Kremer","year":"2012","journal-title":"Hepatology"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.15","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/S0140-6736(80)91849-8","article-title":"Phototherapy for pruritus in primary biliary cirrhosis","volume":"2013","author":"Hanid","year":"1980","journal-title":"Lancet"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.16","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1111\/j.1365-2133.1987.tb05825.x","article-title":"A combination of phototherapy and cholestiramine for the relief of pruritus in primary biliary cirrhosis","volume":"2013","author":"Cerio","year":"1987","journal-title":"Br J Dermatol"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.17","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1111\/j.1651-2227.1994.tb13165.x","article-title":"Cholestatic pruritus: effect of phototherapy on pruritus and excretion of bile acids in urine","volume":"2013","author":"Rosenthal","year":"1994","journal-title":"Acta Paediatr"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.18","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.jhep.2012.04.023","article-title":"Cholestasis-induced pruritus treated with ultraviolet B phototherapy: an observational case series study","volume":"2013","author":"Decock","year":"2012","journal-title":"J Hepatol"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.19","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1111\/j.1529-8019.2005.00032.x","article-title":"Ultraviolet phototherapy for pruritus","volume":"2013","author":"Rivard","year":"2005","journal-title":"Dermatol Ther"},{"key":"2025042709372507000_2013.nov14_1.bcr2013200634.20","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.jaad.2009.08.026","article-title":"Guidelines of care for treatment of psoriasis with phototherapy and photochemotherapy","volume":"2013","author":"Menter","year":"2010","journal-title":"J Am Acad Dermatol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-200634","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T16:37:37Z","timestamp":1745771857000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-200634"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,11,14]]},"references-count":20,"alternative-id":["10.1136\/bcr-2013-200634"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-200634","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2013,11,14]]}}}