When should I consider referring a patient with generalized itching to

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Consider referring a patient with generalized itching to a dermatologist if:

There is unexplained pruritus associated with lymphadenopathy or splenomegaly, as this may indicate underlying serious conditions such as Hodgkin's or non-Hodgkin's lymphoma, warranting urgent specialist assessment .
The itching is persistent and the diagnosis is uncertain or the condition is not responding to standard management, especially in children with atopic eczema .
There are significant social or psychological impacts from the itching or associated skin condition, such as sleep disturbance or poor school attendance in children .
There is suspicion of contact allergic dermatitis or severe recurrent infections related to the skin condition .

When should I consider referring a patient with generalized itching to a dermatologist?