Pruritis is seen in all except – a) Pemphigusb) Lichen simplex chronicusc) Psoriasisd) Contact dennitits

**Core Concept**
Pruritis, or itch, is a common symptom in various dermatological conditions. It is often associated with skin lesions, inflammation, or allergic reactions. The pathophysiology of pruritis involves the activation of sensory nerve endings, the release of histamine and other mediators, and the stimulation of the central nervous system.

**Why the Correct Answer is Right**
Pemphigus, an autoimmune disease characterized by the formation of blisters on the skin and mucous membranes, often presents with pruritis due to the destruction of skin adhesion molecules and the activation of sensory nerve endings. Lichen simplex chronicus, a skin condition caused by chronic scratching and inflammation, typically presents with intense pruritis and thickening of the skin. Psoriasis, an autoimmune disease causing thickened, scaly skin, often presents with pruritis, especially in the early stages. Contact dermatitis, an allergic reaction to substances like soaps, dyes, or metals, typically presents with pruritis, redness, and inflammation.

**Why Each Wrong Option is Incorrect**
**Option A:** Pemphigus is indeed associated with pruritis, making this option incorrect.
**Option B:** Lichen simplex chronicus is a condition that often presents with pruritis, making this option incorrect.
**Option C:** Psoriasis is also associated with pruritis, especially in the early stages, making this option incorrect.

**Clinical Pearl / High-Yield Fact**
When evaluating a patient with pruritis, it is essential to consider all possible causes, including skin conditions, allergies, and systemic diseases. A thorough history, physical examination, and diagnostic tests may be necessary to determine the underlying cause of the pruritis.

**Correct Answer: D. Contact dermatitis is not typically associated with pruritis.