PRURITUS OF LIVER DISEASE (XANTHOMATOUS BILIARY CIRRHOSIS)

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Abstract
FOR MANY years the dermatologist and the internist have been aware of the cutaneous manifestations of liver disease, such as spider nevi, xanthomata, erythema palmare, jaundice, and pruritus, but the mechanism by which some of these are produced has gone unanswered. This is particularly true of pruritus associated with liver disease, and the time-honored fact that the retention of bile salts causes an irritation of the nerve ending does not seem to be the complete answer. It is a well-known fact that in certain severe parenchymal diseases of the liver, as well as in hemolytic anemias, the jaundice may be equally as severe as the obstructive type; yet the pruritus is either absent or much less severe. The purpose of this paper is to point out that generalized pruritus from liver disease is not a rarity in the absence of clinical or laboratory jaundice and that the relief of

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