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

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 ¹.
• The itching is persistent and the diagnosis is uncertain or the condition is not responding to standard management, especially in children with atopic eczema ².
• There are significant social or psychological impacts from the itching or associated skin condition, such as sleep disturbance or poor school attendance in children ².
• There is suspicion of contact allergic dermatitis or severe recurrent infections related to the skin condition ².