Chronic pruritus (> 6 weeks) can be caused by skin diseases and systemic diseases, including malignancies. It is a distressing symptom that requires a precise medical history, thorough physical examination, laboratory and radiological diagnostics. The interpretation of results may sometimes be difficult and may often reveal several pathological findings. This case report demonstrates prostate cancer as a possible underlying disease in a patient with chronic pruritus. Therapy with the selective serotonin reuptake inhibitor paroxetine significantly relieved pruritus, but was less effective when external therapy was discontinued. Most pruritus patients need consecutive or combined aetiological and symptomatic (topical and systemic) therapy.