@moylandavis Hello, and thank you for your kind response to my comment. I have occasionally encountered MCAS in my patients. However, in Germany, proper diagnosis of this syndrome is only possible at a few specialized university hospitals. I still remember the KIT mutation. There is also an interesting story in my history. My daughter, who also suffers from occasional itching, does indeed occasionally show spontaneous local urticaria, which would suggest mast cell involvement. However, this does not occur very often. I have now also considered having genetic testing carried to look for SNV myself. I also found the high prevalence of aquagenic pruritus in Togo, which I saw in the following publication, interesting. Prevalence and Clinical Characteristics of Aquagenic Pruritus among Medical and Pharmacy Students in Lom ́e (Togo). The author summarized: "Aquagenic pruritus is a frequent affection in the study population in Togo. It occurs mainly in males. AP starts immediately or few minutes following a bath and can be generalized or localized in some parts of the body. Family cases of AP have been reported, so it is therefore important to search for a genetic factor which intervenes in the affection." Interestingly, the soothing effect of very hot water or heat itself, or prolonged exposure to UV radiation from sunlight, was not mentioned there. I once asked my health insurance company whether they would be willing to cover the costs of a genetic test. However, I think that health insurance companies will not cover these costs. If I decide to do it and verify it myself, I will report on my results in this group. Today has been good so far with ß-alanine. This morning, the pruritus wanted to return, but with ß-alanine it remained below a threshold that could be described as unpleasant and did not worsen. I wish you a pleasant and successful day.