Pruritus is an important sign of localized or systemic disease and sometimes may be the only symptom of potentially fatal illness. Localized causes of pruritus include stasis dermatitis, atopic dermatitis, contact dermatitis, neurodermatitis and scabies. Generalized pruritus may be caused by environmental factors such as low humidity, skin diseases such as urticaria, or internal diseases such as biliary obstruction, renal failure, hematologic malignancy or acquired immunodeficiency syndrome. Therapy for pruritus depends on identification and treatment of the underlying cause. If no specific etiology is found, therapy is palliative. Avoidance of frequent bathing may be helpful, especially when xerosis plays a role. Topical emollients or short-term therapy with low-potency steroids may also be effective. Oral antihistamines provide nonspecific relief for many patients with intractable pruritus.