Pruritus with no rash points to a rare malignancy

A patient presents with a generalised itch, but few other symptoms

Stewart, a 27-year-old man, visits his GP complaining of mild generalised itch.

Itchy man scratching

This started around two weeks ago and is not improving. He has no past medical history of note.

There is no history of rash and he denies night sweats, weight loss, reduced appetite, cough or recent travel.

He takes no medications or supplements and has no allergies. Stewart does not smoke or take any illicit drugs, and is an occasional drinker.

He works full-time as an account administrator.&nbsp