Skin Symptoms

Living reference work entry


The skin is the largest organ of the body. In life-limiting illnesses, there are a number of important skin manifestations that may cause considerable suffering to patients and, indirectly, to their family and carers. They include pruritus, pathological sweating, skin failure, and malignant cutaneous wounds. This chapter will review the pathophysiological mechanisms, epidemiology, assessment, and management of these manifestations. Each section will be accompanied by a set of evidence-based management recommendations for clinicians.


  1. Alexander S. Malignant fungating wounds: epidemiology, aetiology, presentation and assessment. J Wound Care. 2009;18(7):273–80.PubMedCrossRefGoogle Scholar
  2. Aperis G, Paliouras C, Zervos A, et al. The use of pregabalin in the treatment of uraemic pruritus in haemodialysis patients. J Renal Care. 2010;36(4):180–5.CrossRefGoogle Scholar
  3. Aramwit P, Keongamaroon O, Siritientong T, et al. Sericin cream reduces pruritus in hemodialysis patients: a randomized, double-blind, placebo-controlled experimental study. BMC Nephrol. 2012;13:119.PubMedPubMedCentralCrossRefGoogle Scholar
  4. Australian Wound Management Association. Pan Pacific clinical practice guideline for the prevention and management of pressure injury. West Leederville: Cambridge Media Osborne Park; 2012.Google Scholar
  5. Berg CL, Gollan JL. Primary biliary cirrhosis: new therapeutic directions. Scand J Gastroenterol Suppl. 1992;192:43–9.PubMedCrossRefGoogle Scholar
  6. Bergasa NV. Pruritus of cholestasis. In: Carstens E, Akiyama T, editors. Itch – mechanisms and treatment. Boca Raton: CRC Press; 2014. p. 65.Google Scholar
  7. Bergasa NV, Talbot TL, Alling DW, et al. A controlled trial of naloxone infusions for the pruritus of chronic cholestasis. Gastroenterology. 1992;102(2):544–9.PubMedCrossRefGoogle Scholar
  8. Bergasa NV, Liau S, Homel P, et al. Hepatic Met-enkephalin immunoreactivity is enhanced in primary biliary cirrhosis. Liver. 2002;22(2):107–13.PubMedCrossRefGoogle Scholar
  9. Bergasa NV, McGee M, Ginsburg IH, Engler D. Gabapentin in patients with the pruritus of cholestasis: a double-blind, randomized, placebo-controlled trial. Hepatology. 2006;44:1317–23.PubMedCrossRefGoogle Scholar
  10. Beuers U, Kremer AE, Bolier R, et al. Pruritus in cholestasis – facts and fiction. Hepatology. 2014;60(1):399–407.PubMedCrossRefGoogle Scholar
  11. Booken N, Heck M, Nicolay JP. Oral aprepitant in the therapy if refractory pruritus in erythrodermic cutaneous T-cell lymphoma. Brit J Dermatol. 2011;164:665–83.Google Scholar
  12. Breneman DL, Cardone JS, Blumsack RF, et al. Topical capsaicin for treatment of haemodialysis-related pruritus. J Am Acad Dermatol. 1992;26:91–4.PubMedCrossRefGoogle Scholar
  13. Brennan F. The pathophysiology of pruritus – a review for clinicians. Prog Pall Care. 2016;24(3):133–46.CrossRefGoogle Scholar
  14. Brown G. Long term outcomes of full thickness pressure areas: healing and mortality. Ostomy Wound Manage. 2003;9(10):42–50.Google Scholar
  15. Calder K, Bruera E. Thalidomide for night sweats in patients with advanced cancer. Palliat Med. 2000;14:77–8.PubMedCrossRefGoogle Scholar
  16. Chen YC, Chiu W-T, Wu M-S. Therapeutic effect of topical gamma-linolenic acid on refractory uremic pruritus. Am J Kidney Dis. 2006;48:69–76.PubMedCrossRefGoogle Scholar
  17. Combs SA, Teixeira JP, Germain MJ. Pruritus in kidney disease. Semin Nephrol. 2015;35(40):383–91.PubMedPubMedCentralCrossRefGoogle Scholar
  18. Datna DV, Sherlock S. Cholestyramine for long term relief of the pruritus complicating intrahepatic cholestasis. Gastroenterology. 1966;50(3):323–32.Google Scholar
  19. Dawn AG, Yosipovitch G. Butorphanol for the treatment of intractable pruritus. J Am Acad Dermatol. 2006;54:527–31.PubMedCrossRefGoogle Scholar
  20. Decock S, Roelandts R, Steenbergen WV, et al. Cholestasis-induced pruritus treated with ultraviolet-B phototherapy: an observational case series. J Hepatol. 2012;57(3):637–41.PubMedCrossRefGoogle Scholar
  21. Demierre M-F, Taverna J. Mirtazapine and gabapentin for reducing pruritus in cutaneous T-cell lymphoma. J Am Acad Dermatol. 2006;55(3):543–4.PubMedCrossRefGoogle Scholar
  22. Dowsett C. Malignant fungating wounds: assessment and management. Br J Community Nurs. 2002;7(8):394–400.PubMedCrossRefGoogle Scholar
  23. Duque MI, Yosipovitch G, Fleisher AB, et al. Lack of efficacy of tacrolimus ointment 0.1% for treatment of hemodialysis-related pruritus: a randomized, double-blind, vehicle-controlled study. J Am Acad Dermatol. 2005;52:519–21.PubMedCrossRefGoogle Scholar
  24. Duval A, Dubertret L. Aprepitant as an antipruritic agent ? N Engl J Med. 2009;361(14):1415–6.PubMedCrossRefGoogle Scholar
  25. Ghent CN, Carruthers SG. Treatment of pruritus in primary biliary cirrhosis with rifampacin. Results of a double-blind, crossover, randomized trial. Gastroenterology. 1988;94:488–93.PubMedCrossRefGoogle Scholar
  26. Gilchrest BA, Rowe JW, Brown RS, et al. Relief of uremic pruritus with ultraviolet phototherapy. N Engl J Med. 1977;297:136–8.PubMedCrossRefGoogle Scholar
  27. Gilchrest BA, Rowe JW, Brown RS, et al. Ultraviolet phototherapy of uremic pruritus. Ann Intern Med. 1979;91:17–21.PubMedCrossRefGoogle Scholar
  28. Gingold AR, Bergasa NV. The cannabinoid agonist WIN 55, 212-2 increases nocioception threshold in cholestatic rats: implications for the treatment of the pruritus of cholestasis. Life Sci. 2003;73(2):2741–7.PubMedCrossRefGoogle Scholar
  29. Goode PS, Allman RM. The prevention and management of pressure ulcers. Med Clin North Am. 1989;73(6):1511–24.PubMedCrossRefGoogle Scholar
  30. Gonclaves F. Thalidomide for the control of severe paraneoplastic pruritus associated with Hodgkin’s disease. Am J Hosp Palliat Care. 2010;27(7):486–7.CrossRefGoogle Scholar
  31. Grocott PR. Palliative management of Fungating malignant wounds. Eur J Cancer. 1995;31:S308.CrossRefGoogle Scholar
  32. Haffenreffer S. De pruritu, Nosodochium in Quo Cutis. In: Eique Adhaerentium Partium, Affectus Omnes, Singulari Methodo, Et Cognoscendi Et Curandi Fidelissime Traduntur. Ulm: Kuhnen Balthasar; 1660. p. 98–102.Google Scholar
  33. Heathcote EJ. Is rifampicin a safe and effective treatment for pruritus caused by chronic cholestasis? Nat Clin Pract Gastroenterol Heapatol. 2007;494:200–1.CrossRefGoogle Scholar
  34. Hobbs RN. Walk with me – physicians’ and patients’ stories and their role in palliative care education. J Palliat Care. 1993;9(2):41–6.PubMedGoogle Scholar
  35. Irvine B. Developments in palliative nursing in and out of the hospital settings. Br J Nurs. 2016;2(4):218–24.CrossRefGoogle Scholar
  36. Karadag E, Kilic SP, Karatay G, et al. Effect of baby oil on pruritus, sleep quality, and quality of life in hemodialysis patients: pretest-post-test model with control groups. Jpn J Nurs Sci. 2014;11:180–9.PubMedCrossRefGoogle Scholar
  37. Kilic A, Gul U, Soylu S. Skin findings in internal malignant diseases. Int J Dermatol. 2007;46:1055–60.PubMedCrossRefGoogle Scholar
  38. Kim KH, Lee MS, Choi SM. Acupuncture for treating uremic pruritus in patients with end-stage renal disease; a systematic review. J Pain Symptom Manag. 2010;40:117–25.CrossRefGoogle Scholar
  39. Ko MJ, Yang JY, HY W, et al. Narrowband ultraviolet B phototherapy for patients with refractory uraemic pruritus: a randomized controlled trial. Brit J Dermatol. 2011;165:633–9.CrossRefGoogle Scholar
  40. Kremer AE, Beuers U, Oude-Elferink RP, et al. Pathogenesis and treatment of pruritus in cholestasis. Drugs. 2008;68:2163–82.PubMedCrossRefGoogle Scholar
  41. Kremer AE, Martens JJ, Kulik W, et al. Lysophosphatidic acid is a potential mediator of cholestatic pruritus. Gastroenterology. 2010;139:1008–18.PubMedCrossRefGoogle Scholar
  42. Kremer AE, van Dijk R, Leckie P, et al. Serum autotaxin is increased in pruritus of cholestasis, but not of other origin, and responds to therapeutic interventions. Hepatology. 2012;56:1391–400.PubMedCrossRefGoogle Scholar
  43. Kremer AE, Bolier R, van Dijk R, et al. Advances in pathogenesis and management of pruritus in cholestasis. Dig Dis. 2014;32:637–45.PubMedCrossRefGoogle Scholar
  44. Kumagai H, Ebata T, Takamori K, et al. Effect of a novel kappa-receptor agonist, nalfurafine hydrochloride, on severe itch in 337 haemodialysis patients: a phase III, randomized, double-blind, placebo controlled study. Nephrol Dial Transplant. 2010;25(4):1251–7.PubMedCrossRefGoogle Scholar
  45. Kumagai H, Ebata T, Takamori K, et al. Efficacy and safety of a novel k-agonist for managing intractable pruritus in dialysis patients. Am J Nephrol. 2012;36:175–83.PubMedCrossRefGoogle Scholar
  46. Kuypers DR, Claes K, Evenepoel P, et al. A prospective proof of concept study of the efficacy of tacrolimus ointment on uremic pruritus (UP) in patients on chronic dialysis therapy. Nephrol Dial Transplant. 2004;19:1895–901.PubMedCrossRefGoogle Scholar
  47. Langemo DK, Brown G. Skin fails too: acute, chronic and end-stage skin failure. Adv Skin Wound Care. 2006;19(4):206–11.PubMedCrossRefGoogle Scholar
  48. La Puma J. The ethics of pressure ulcers. Adv Skin Wound Care. 1991;4(2):43–5.Google Scholar
  49. Lau T, Leung S, Lau W. Gabapentin for uremic pruritus in hemodialysis patients: a qualitative systematic review. Can J Kidney Health Dis. 2016;3:1–14.CrossRefGoogle Scholar
  50. Legroux-Crespel E, Cledes J, Misery L. A comparative study on the effects of naltrexone and loratadine on uremic pruritus. Dermatology. 2004;208:326–30.PubMedCrossRefGoogle Scholar
  51. Lin TC, Lai YH, Guo SE, et al. Baby oil therapy for uremic pruritus in hemodialysis patients. J Clin Nurs. 2012;21:139–48.PubMedCrossRefGoogle Scholar
  52. Lo S, Hu W, Hayter M, Chang S, Hsu M, Wu L. Experiences of living with a malignant fungating wound: a qualitative study. J Clin Nurs. 2008;17(20):2699–708.PubMedCrossRefGoogle Scholar
  53. Maida V. Nabilone for the treatment of paraneoplastic night sweats: a report of four cases. J Palliat Med. 2008;11(6):929–34.PubMedCrossRefGoogle Scholar
  54. Maida V, Ennis M, Kuziemsky C, Trozzolo L. Symptoms associated with malignant wounds: a prospective case series. J Pain Symptom Manag. 2009;37(2):206–11.CrossRefGoogle Scholar
  55. Makhlough A, Ala S, Haj-Heydari Z, et al. Topical capsaicin therapy for uremic pruritus in patients on hemodialysis. Iran J Kidney Dis. 2010;4:137–40.PubMedGoogle Scholar
  56. Mathur VS, Lindberg J, Germain M, et al. A longitudinal study of uremic pruritus in hemodialysis patients. Clin J Am Soc Nephrol. 2010;5:1410–9.PubMedPubMedCentralCrossRefGoogle Scholar
  57. Mayo MM, Handem I, Saldana S, et al. Sertraline as a first line treatment for cholestatic pruritus. Hepatology. 2007;45:666–74.PubMedCrossRefGoogle Scholar
  58. McCormick PA, Scott F, Epstein O, et al. Thalidomide as therapy for primary biliary cirrhosis: a double-blind placebo controlled pilot study. J Hepatol. 1994;21:496–9.PubMedCrossRefGoogle Scholar
  59. McMurray V. Managing patients with fungating malignant wounds. Nurs Times. 2003;99(13):55–7.PubMedGoogle Scholar
  60. Mettang T. Pruritus in kidney disease. In: Carstens E, Akiyama T, editors. Itch – mechanisms and treatment. Boca Raton: CRC Press; 2014.Google Scholar
  61. Morton CA, Lafferty M, Lau C, et al. Pruritus and skin hydration during dialysis. Nephrol Dial Transplant. 1996;11:2031–6.PubMedCrossRefGoogle Scholar
  62. Murphy M, Reaich D, Pai P, et al. A randomized, placebo-controlled, double-blind trial of ondansetron in renal itch. Brit J Dermatol. 2003;148(2):314–7.CrossRefGoogle Scholar
  63. Murtagh FEM, Addington-Hall JM, Edmonds PM, et al. Symptoms in advanced renal disease: a cross-sectional survey of symptom prevalence in stage 5 chronic kidney diseases managed without dialysis. J Palliat Med. 2007;10(6):1266–76.PubMedCrossRefGoogle Scholar
  64. Nasrollahi A, Miladipour A, Ghanei E, et al. Montelukast for treatment of refractory pruritus in patients on hemodialysis. Iran J Kidney Dis. 2007;1(2):73–7.PubMedGoogle Scholar
  65. National Pressure Ulcer Advisory Panel. NPUAP Pressure Injury Stages. United States of America: National Pressure Ulcer Advisory Panel; 2016 (Cited 2016 October 10). Available from:
  66. Naylor W. Assessment and management of pain in fungating wounds. Br J Nurs. 2001;10(Sup5):S33–56.PubMedCrossRefGoogle Scholar
  67. Neff GW, O’Brien CB, Reddy KR, et al. Preliminary observation with dronabinol in patients with intractable pruritus secondary to cholestatic liver disease. Am J Gastroenterol. 2002;97(8):2117–9.PubMedCrossRefGoogle Scholar
  68. Nieto-Posadas A, Picazo-Juaraez G, Llorente I, et al. Lysophosphatidic acid directly activates TRPV1 through a C-binding site. Nat Chem Biol. 2012;8:78–85.CrossRefGoogle Scholar
  69. Noble H, Meyer J, Bridge J, et al. Exploring symptoms in patients managed without dialysis: a qualitative research study. J Ren Care. 2010;36(1):9–15.PubMedCrossRefGoogle Scholar
  70. Papiou ADP, Emerson NM, Patel TS, et al. Voxel-based morphometry and arterial spin labelling fMRI reveal neuropathic and neuroplastic features of brain processing of itch in end-stage renal disease. J Neurophysiol. 2014;112:1729–38.CrossRefGoogle Scholar
  71. Patel TS, Freedman BI, Yosipovitch G. An update on pruritus associated with CKD. Am J Kidney Dis. 2007;50:11–20.PubMedCrossRefGoogle Scholar
  72. Pauli-Magnus C, Mikus G, Alscher DM, et al. Naltrexone does not relieve uremic pruritus: results of a randomized, double-blind, placebo-controlled crossover study. J Am Soc Nephrol. 2000;11:514–9.PubMedGoogle Scholar
  73. Peer G, Kivity S, Agami O, et al. Randomised crossover trial of naltrexone in uremic pruritus. Lancet. 1996;348:1552–4.PubMedCrossRefGoogle Scholar
  74. Pisoni RL, Wikstrom B, Elder SJ, et al. Pruritus in haemodialysis patients: international results from Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant. 2006;21:3495–505.PubMedCrossRefGoogle Scholar
  75. Probst S, Arber A, Faithful S. Malignant fungating wounds – the meaning of living in an unbounded body. Eur J Oncol Nurs. 2013:38–45.Google Scholar
  76. Rayner H, Baharani J, Smith S, et al. Uraemic pruritus: relief of itching by gabapentin and pregabalin. Nephron Clin Pract. 2012;122:75–9.PubMedCrossRefGoogle Scholar
  77. Razeghi E, Ejkandari D, Ganji M, et al. Gabapentin and uremic pruritus in hemodialysis patients. Ren Fail. 2009;31(2):85–90.PubMedCrossRefGoogle Scholar
  78. Rowe B, Yosipovitch G. Paraneoplastic itch management. In: Szepietowski JC, Weisshaar E, editors. Itch – Management in Clinical Practice. Basel: Karger; 2016. p. 149–54.CrossRefGoogle Scholar
  79. Rubenstein M, Duvic M. Cutaneous manifestations of Hodgkin’s Disease. Int J Dermatol. 2006;45:252–6.CrossRefGoogle Scholar
  80. Schank JE. Kennedy terminal ulcer: the “ah-ha!” moment. Ostomy Wound Manage. 2009;55(9):40–44.PubMedGoogle Scholar
  81. Seaman S. Management of malignant fungating wounds in advanced cancer. Semin Oncol Nurs. 2006;22(3):185–93.PubMedCrossRefGoogle Scholar
  82. Shakiba M, Sanadgol H, Azmoude HR et al. Effect of sertraline on uremic pruritus improvement in ESRD patients. Int J Nephrol. 2012:363901; 1–5.Google Scholar
  83. Shavit L, Grenader T, Lifschitz M, et al. Use of pregabalin in the management of chronic uremic pruritus. J Pain Symptom Manag. 2013;45(4):776–81.CrossRefGoogle Scholar
  84. Sibbald RG, Krasner DL, Lutz J. SCALE: skin changes at life’s end final consensus statement. Adv Skin Wound Care. 2009;23(5):225–36.CrossRefGoogle Scholar
  85. Silva SRB, Viana PCF, Lugon NV, et al. Thalidomide for the treatment of uremic pruritus: a crossover randomized double-blind trial. Nephron. 1994;67:270–3.PubMedCrossRefGoogle Scholar
  86. Smith CJ, Johnson JM. Responses to hyperthermia. Optimizing heat dissipation by convection and evaporation: neural control of skin blood flow and sweating in humans. Auton Neurosci. 2016;196:25–36.PubMedCrossRefGoogle Scholar
  87. Solak Y, Biyik Z, Atalay H, et al. Pregabalin versus gabapentin in the treatment of neuropathic pruritus in maintenance haemodialysis patients: a prospective, crossover study. Nephrology. 2012;17:71–717.CrossRefGoogle Scholar
  88. Stander S, Luger TA. NK-I antagonists and itch. In: Cowan A, Yosipovitch A, editors. Pharmacology of itch. Heidelberg: Springer; 2015.Google Scholar
  89. Swain MG. Pruritus and lethargy in the primary biliary cirrhosis patient. In: Neuberger J, editor. Primary biliary cirrhosis. Eastbourne: West End Studios; 1999. p. 75–81.Google Scholar
  90. Ta Y, Patel TS, Camacho F, et al. A pramoxine-based anti-itch lotion is more effective than a control lotion for the treatment of uremic pruritus in adult hemodialysis patients. J Dermatol Treat. 2009;20:76–81.CrossRefGoogle Scholar
  91. Tan JK, Haberman HF, Coldman AJ. Identifying effective treatments for uremic pruritus. J Am Acad Dermatol. 1991;25(5 Pt 1):811–8.PubMedCrossRefGoogle Scholar
  92. Tandon P, Rowe BH, Vandermeer B, et al. The efficacy and safety of bile acid binding agents, opioid antagonists, or rifampicin in the treatment of cholestasis-associated pruritus. Am J Gastroenterol. 2007;102(7):1528–36.PubMedCrossRefGoogle Scholar
  93. Tarng DC, Cho YL, Liu HN, et al. Hemodialysis-related pruritus: a double-blind, placebo-controlled, crossover study of capsaicin 0.025% cream. Nephron. 1996;72:617–22.PubMedCrossRefGoogle Scholar
  94. Terg R, Coronel E, Sorda J, et al. Efficacy and safety of oral naltrexone treatment for pruritus of cholestasis, a crossover, double blind, placebo-controlled study. J Hepatol. 2002;37(60):717–22.PubMedCrossRefGoogle Scholar
  95. Thornton JR, Losowsky MS. Opioid peptides and primary biliary cirrhosis. Br Med J. 1988;297(6662):1501–4.CrossRefGoogle Scholar
  96. To T, Clark K, Lam L, et al. The role of ondansetron in the management of cholestatic or uremic pruritus – a systematic review. J Pain Symptom Manag. 2012;44:725–30.CrossRefGoogle Scholar
  97. Trivedi M, Bergasa NV. Serum concentrations of substance P in cholestasis. Ann Hepatol. 2010;99(2):177–80.Google Scholar
  98. Twycross R, Wilcock A, Howard P, editors. Palliative Care Formulary. 5th ed. Nottingham: Palliative Care; 2014.Google Scholar
  99. Villafranca JJA, Siles M, Casanova M, et al. Paraneoplastic pruritus presenting with Hodgkin’s lymphoma; a case report. J Med Case Reports. 2014;8:300.CrossRefGoogle Scholar
  100. Villamil AG, Bandi JC, Galdame O, et al. Efficacy of lidocaine in the treatment of pruritus in patients with chronic cholestatic liver diseases. Am J Med. 2005;118(10):1160–3.PubMedCrossRefGoogle Scholar
  101. Waran E. Doctor, I am sweating on just one side of my body: unilateral hyperhidrosis associated with mesothelioma. Clin Case Rep. 2016;4(5):533–4.PubMedPubMedCentralCrossRefGoogle Scholar
  102. Weisshaar E, Dunkler N, Rohl FW, et al. Antipruritic effects of two different 5-HT3 receptor antagonists and an antihistamine in haemodialysis patients. Exp Dermatol. 2004;24:298–304.CrossRefGoogle Scholar
  103. Weisshaar E, Szepietowski JC, Drashow U, et al. European guideline on chronic pruritus. Acta Derm Venereol. 2012;92:563–81.PubMedCrossRefGoogle Scholar
  104. Weisshaar E, Weiss M, Mettang T, Yosipovitch G, Zylicz Z. Paraneoplastic itch: an expert position statement from the Special Interest Group (SIG) of the International Forum on the Study of Itch (IFSI). Acta Derm Venerol. 2015;95:261–5.PubMedCrossRefGoogle Scholar
  105. Wikstrom B, Gellert R, Ladefoged SD, et al. Kappa-opioid system in uremic pruritus : multicentre, randomized, double-blind, placebo-controlled clinical studies. J Am Soc Nephrol. 2005;16:3742–7.PubMedCrossRefGoogle Scholar
  106. Wilson V. Assessment and management of fungating wounds: a review. Br J Community Nurs. 2005;10(Sup1):S28–34.PubMedCrossRefGoogle Scholar
  107. Witkowski JA, Parrish LC. The decubitus ulcer. Skin failure and destructive behaviour. Int J Dermatol. 2000;39(12):894–6.PubMedCrossRefGoogle Scholar
  108. Wolfhagen FHJ, Sternieri E, Hop WCJ, et al. Oral naltrexone treatment for cholestatic pruritus: a double-blind, placebo-controlled study. Gastroenterology. 1997;113(4):1264–9.PubMedCrossRefGoogle Scholar
  109. Worley CA. The permissible pressure ulcer. Dermatol Nurs. 2007;19:384–5.PubMedGoogle Scholar
  110. Yoshimoto-Furuie K, Yoshimoto K, Tanaka T, et al. Effects of oral supplementation with evening primrose oil for six weeks on plasma essential fatty acids and uremic skin symptoms on hemodialysis patients. Nephron. 1999;81:151–9.PubMedCrossRefGoogle Scholar
  111. Yosipovitch G, Bernhard JD. Clinical practice – chronic pruritus. New Engl J Med. 2013;368:1625–34.PubMedCrossRefGoogle Scholar
  112. Young TA, Patel TS, Camacho F, et al. A pramoxine-based anti-itch lotion is more effective than a control for the treatment of uremic pruritus in adult hemodialysis patients. J Dermatol Treat. 2009;20(2):76–81.CrossRefGoogle Scholar
  113. Yue J, Jiao S, Xiao Y, et al. Comparison of pregabalin with ondansetron in treatment of uraemic pruritus in dialysis patients: a prospective, randomized, double-blind study. Int Urol Nephrol. 2015;47(1):161–7.PubMedCrossRefGoogle Scholar
  114. Zylicz Z, Krajnik M. Flushing and sweating in an advanced breast cancer patient relieved by Olanzapine. J Pain Sympt Manage. 2003;25(6):494–5.CrossRefGoogle Scholar

Authors and Affiliations

  1. 1.Palliative Care PhysicianSt George and Calvary HospitalsSydneyAustralia
  2. 2.Wound Management Clinical Nurse ConsultantSt George HospitalSydneyAustralia
  3. 3.Palliative Care Clinical Nurse ConsultantSt George HospitalSydneyAustralia

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