A 71-year-old male has severe generalized pruritus without a rash of 9 months duration. He had been previously treated with antihistamines and oral corticosteroids without success. The patient's medical history included a number of other medical problems. Three years back he had developed gradually progressive, bilateral upper and lower extremity numbness and weakness that was diagnosed as chronic inflammatory demyelinating polyneuropathy (CIDP) by electromyography and nerve conduction velocity (EMG/NCV) testing.
He was placed on oral corticosteroids for the CIDP, although it is not clear that this treatment was at all helpful. He reported having had a “stroke” nine years prior although repeated imaging of the brain demonstrated no evidence of an old infarct. He was also diagnosed with asthma and chronic rhinosinusitis 3 years before and had hyperlipidemia, type 2 diabetes mellitus, and…
