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Common nonspecific changes • Generalized pruritus, often worse at night and on the back and extensor surfaces, frequently without a primary rash; secondary excoriations, lichen simplex, and prurigo nodularis are typical from chronic scratching. • Xerosis and acquired ichthyosis with rough, scaly, dry skin due to sweat/sebaceous gland dysfunction and high transepidermal water loss. • Pigmentary changes such as diffuse pallor from anemia and a gray‑brown or yellowish tinge, especially in sun‑expos
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