IL4 and Cowden syndrome 1: Furthermore, the Th1 response in classic scabies is associated with production of IFN- γ, TNF- α, and IL-2 that activate pruriceptors, whereas the Th2 response in CS is associated with activation of pruriceptors via B-cell activation, production of IL-4, IL-5, IL-13, and IL-31, and IgE-mediated mast cell activation (Misery 2014; Kim et al. 2021).