Erythema, pruritus, and even inflamed nodules, verrucose papules, or granulomas may present. The severity of symptoms vary, with dermatitis, pruritus and papular urticaria being common. Pirfenidone is known to cause photosensitivity reactions, rash, pruritus and dry skin. Irritation and itching of the vulva is called pruritus vulvae. Antidepressants and naltrexone may be used to control pruritus (itchiness). Symptoms can range from none (asymptomatic) to abdominal pain, nausea and vomiting, or pruritus ani. It acts against interleukin 31 (IL-31), which is a cytokine involved in causing itchiness (pruritus). These may be followed by polyuria, polydipsia, weakness, insomnia, nervousness, pruritus and ultimately kidney failure. Rare applications included stomach ache, depression, diarrhea, diminished appetite, pruritus, hemorrhage, Basedow syndrome and malaria. Reported side effects include headache, fever, pruritus and gastrointestinal upset. Symptoms include a painful lump, bleeding, pruritus ani, tenesmus, discharge or possibly fecal incontinence. The lesion may be asymptomatic or accompanied by mild pruritus, pain, and fever. It has also completed a phase III clinical trial for uremic pruritus in hemodialysis patients. In Germany, chlorpromazine still carries label indications for insomnia, severe pruritus, and preanesthesia. Such examples include emotional "blunting" with antidepressants, pruritus with opiates, and blurred vision with anticholinergics.