Severe pruritus is frequently associated with myeloproliferative and other systemic illnesses, and often fails to respond to conventional measures, We used danazol (Danocrine(TM)), a synthetic attenuated androgen, in the treatment of severe pruritus refractory to conventional therapy. Eight patients had myeloproliferative disorders (MPD), seven had autoimmune disorders, and seven had skin diseases, Danazol at 400-800 mg/day was administered, and previous medications were tapered off, When itching was controlled with danazol alone, the dosage was reduced or discontinued, and resumed if itching recurred, Clinical responses were graded, and side effects were monitored, Overall, in 12 of 22 patients refractory to other measures, itching was controlled with danazol alone, In 10 patients itching returned when danazol was discontinued or dosage was reduced, and was relieved upon resumption or increase of dosage, Danazol therapy was continued for up to 5 years in responders, No serious side effects were observed, Our experience indicates that danazol is a good alternative for patients with severe pruritus associated with myeloproliferative and other systemic disorders. (C) 1996 Wiley-Liss, Inc.