Aquagenic pruritus in an adolescent effectively managed with ß-alanine supplementation.

Aquagenic pruritus is a rare debilitating condition, which can be idiopathic, iatrogenic, or associated with systemic disease. In idiopathic cases, treatment can be challenging as options are limited and of variable efficacy. Here, we report the case of a teenage boy with refractory idiopathic aquagenic pruritus effectively managed with administration of ß-alanine supplementation, a treatment gaining traction in lay media but not yet reported in the medical literature. This report adds to the limited options published for treatment of idiopathic aquagenic pruritus in pediatric patients.

Following the north star: radial marker lines help preserve anatomic landmarks after local injection of anesthetic.

Injection of local anesthetic can result in distortion of local anatomic architecture. "Following the North Star" is a technique that uses radial markings to aid in better preservation of surgical landmarks.