A retrospective study of 44 cases of generalized pruritus (GP) was undertaken to determine the incidence of systemic disease in this population. This data was compared to that of a group of 44 age- and sex-matched psoriatic controls. We found 13 (30%) of the GP cases to have a systemic disease that in the literature is believed to be associated with GP, versus 10 (23%) in the psoriasis group. Excluding hypothyroidism and diabetes mellitus, two disorders with questionable relationship to GP, the number of pruritus patients with an associated systemic disease was reduced to 8 (18%) compared to only 1 (2%) psoriatic patient, a difference which is statistically significant (p less than 0.02). In 6 (14%) of the GP patients a temporal relationship of systemic disease and GP was suggested. Recommendations for outpatient workup of GP are given. Patient follow-up of 1 to 6 1/2 years revealed that 29 (66%) of the patients had persistent itching. The mean duration of itching to the time of the present follow-up was 57.7 months.