CHRONIC PRURITUS: KEY UPDATES IN THE 2025 EUROPEAN GUIDELINE

Abstract

  Chronic pruritus (itch lasting ≥ 6 weeks) is one of the most common symptoms in dermatology, allergology and general practice, affecting approximately one in five people during their lifetime, while the annual incidence is about 7% [1, 4]. The updated European guideline published in 2025 substantially revised the 2019 edition [1]. This article summarises the main changes: a modern definition of pruritus [2], refined classification and diagnostic algorithm, and advances in systemic treatment, including biologics (dupilumab, nemolizumab), Janus kinase (JAK) inhibitors, difelikefalin for uremic pruritus, and ileal bile acid transporter (IBAT) inhibitors and bezafibrate for cholestatic pruritus. The article also reviews core concepts—the pathophysiology of pruritus, the itch–scratch cycle, and daily skin-care principles. The role of the general practitioner in initial assessment, symptomatic management and timely referral is emphasised.