OBJECTIVES: The severity of pruritus may be modest, but it may also be very significant and cause considerable discomfort to the patient. In an difficult economic context, the public health burden is increasingly often a legitimate concern for health authorities. A tool designed to evaluate the burden needs to be made available to health professionals in order to conduct an objective assessment.  To explore the handicap, in the largest sense, generated by pruritus (scratching or itching) using a questionnaire to express the burden of the symptom on the daily life of patients. METHODS: The questionnaire was developed following a strict methodological process, involving a multidisciplinary team incorporating various players (doctors, nurses, social workers) who are involved in the treatment of patients and caring for their families in order to guarantee its credibility and reliability. A review of the literature and discussions with the children and their families were conducted in order to identify the concepts related to the pathology. RESULTS: Exploratory assessments showed that the concept of burden could be structured around 2 modules: frequency and severity for the first module; daily life, family and personal relationships, work and psychological impact for the second module. Forty-two preliminary items were identified following a first discussion. A first analysis managed to reduce these items to 29 whilst conserving the 2 modules but making it easier to use the analysis. CONCLUSIONS: Whilst being a frequent symptom, particularly dermatologically, the overall consequences of pruritus in terms of public health are difficult to assess by clinical or quality of life aspects alone as its impact can be multidimensional. Several existing questionnaires attempt to assess one or other of these components; the BOSIP (Burden of Scratching, Itching and Pruritus) questionnaire takes them all into consideration in order to explain every angle of the handicap generated.