Pruritus, or itching, is a particularly distressing and often refractory symptom which patients may experience at the end of life. Scratching associated with itching may damage the skin and compromise its function as a barrier. In addition to superficial skin irritation or infection, many pruritic conditions have underlying systemic causes. Patients may describe pruritus as burning, tingling, numbness, or crawling in the skin. Itch may be mediated by histamine, serotonin, and pro-inflammatory cytokines. Patients may experience worsening agitation, fatigue, insomnia, and reduced quality of life as a result.....Read More