Pawlotsky et al,1 in an otherwise in-depth and complete review of the dermatologic manifestations of hepatitis in the October 1995 issue of the Archives, failed to cite pruritus as a symptom of hepatitis C as described by myself and Teresa Wright.2 This association was confirmed by the article of Kanazawa et al.3
Recognizing pruritus as a manifestation of hepatitis C is important for 2 reasons. First, pruritus may be the presenting sign of hepatitis C, and therefore it should be a consideration in the diagnostic evaluation of any patient suffering from pruritus not secondary to a primary skin disorder. Second, the pruritus, which may vary in intensity from mild to disabling severity, may be the patient's primary manifestation of hepatitis C and may be effectively alleviated by prudent therapeutic intervention. Since publication of my article, I have treated an additional patient with severe pruritus and hepatitis C