Commonest presentation of primary biliary cirrhosis?

Ans is 'a' i.e., Pruritus Harrison writes "Most patients with Primary biliary cirrhosis are asymptomatic, and the disease is initially detected on the basis of elevated serum alkaline phosphatase levels during routine screening. Often the earliest symptom is pruritus, which may be either generalized or limited initially to the palms and soles. In addition fatigue is commonly a prominent early symptom. After several months or years, jaundice and gradual darkening of the exposed areas of the skin (melanosis) may ensue."