“…4 Interleukin (IL)-31 is a pruritogenic cytokine released by many of these cells and it is upregulated in the skin of patients with PN. 4 Alitretinoin downregulates the activity of these inflammatory cells. 2 In particular, mast cell downregulation is important, as it mediates pruritus through the release of histamine, tryptase, prostaglandins, leucotrienes, IL-2, IL-4, IL-6, IL-31 and nerve growth factor (NGF).…”