History and clinical findings: A 51 year old female patient complained about marked pruritus of the whole integument. Since seven years she had been taking a two phase combination of estrogens and gestagen because of climacteric symptoms. 24 years ago severe pruritus occurred especially at the hands during the last trimenon of her first pregnancy whereas 7 years later during the subsequent pregnancy pruritus was absent. Physical examination revealed multiple excoriations over the whole body. No other relevant pathological findings were noted.
Investigations: Laboratory findings, chest X-ray and abdominal sonography were normal.
Treatment and course: Neither oral administration of an antihistaminic drug nor topical application of betamethasone improved the situation to a relevant extent. For 12 months the occurrence of pruritus had not been referred to hormonal treatment by the physicians in charge. Complete cessation of pruritus was seen within a few days after the patient had stopped hormonal medication on her own.
Conclusion: Patients should be asked for pregnancy associated pruritus or jaundice before receiving drug combinations with estrogens and gestagens. In case of a positive history, the physician should inform them about possible side effects such as pruritus and icterus.