Primary sclerosing cholangitis
ICD-10 K83.0 · ICD-11 DB96.2

Moderate to Severe Skin Itching (Pruritus) in Large Duct Primary Sclerosing Cholangitis

When patients with large duct primary sclerosing cholangitis develop moderate to severe pruritus, a structured clinical evaluation is essential before treatment decisions are made. The severity and progression of the itching guide the workup.

This protocol applies to patients with large duct sclerosing cholangitis experiencing moderate to severe pruritus (significant, persistent skin itching). In this population, identifying whether a structural biliary cause underlies the symptom is a recommended first step — progressive pruritus in large duct disease warrants active investigation.

Clinical Approach

The initial recommended step is to assess whether relevant bile duct strictures may be responsible for the pruritus. When such strictures are identified and are accessible, endoscopic intervention is the indicated approach — though the specific method and sequence depend on what is found.

Full evaluation criteria, intervention steps, and decision sequence available in the complete protocol.
Instant Access to Structured Evidence-Based Regimens

References

  1. It is recommended to exclude relevant bile duct strictures in large duct sclerosing cholangitis as the cause of progressive pruritus.
  2. It is recommended to exclude relevant bile duct strictures in large duct sclerosing cholangitis as the cause of progressive pruritus. If present and reachable, relevant strictures should be treated by endoscopic balloon dilatation (or stenting, if balloon dilatation alone is insufficient) after brushing.

DOI: 10.1016/j.jhep.2022.05.011

View source ↗