Hypersensitivity Pneumonitis: This condition is caused by an allergic reaction to inhaled substances, leading to inflammation of the lungs and potentially causing pruritis due to the body's immune response. The recurrent pneumonia aspect fits with the chronic or recurrent exposure to the allergen.

Allergic Bronchopulmonary Aspergillosis (ABPA): This is an allergic reaction to a fungus that can cause both respiratory symptoms, including recurrent pneumonia, and systemic symptoms like pruritis due to the allergic nature of the disease.
Chronic Eosinophilic Pneumonia: Characterized by an accumulation of eosinophils in the lungs, this condition can cause pneumonia-like symptoms and is often associated with asthma and atopy, which could explain the pruritis.
Sarcoidosis: Although less directly linked to pruritis and recurrent pneumonia, sarcoidosis can cause a wide range of symptoms including skin manifestations and lung involvement, making it a consideration in patients with these symptoms.

Lymphoma: Certain types of lymphoma, particularly cutaneous T-cell lymphoma, can cause pruritis, and lymphoma can also involve the lungs, leading to pneumonia-like symptoms. Missing this diagnosis could be fatal.
HIV/AIDS: Immunocompromised patients are at a higher risk for recurrent infections, including pneumonia. Pruritis can also be a symptom in HIV/AIDS patients due to various opportunistic infections or the disease process itself.
Cystic Fibrosis: While more commonly diagnosed in childhood, cystic fibrosis can present in adults and is characterized by recurrent respiratory infections and could potentially cause pruritis due to associated liver disease or other systemic effects.

Eosinophilia-Myalgia Syndrome: A rare condition characterized by elevated eosinophils and can cause a variety of symptoms including pruritis and potentially respiratory issues.
Hyper-IgE Syndrome (Job Syndrome): Characterized by recurrent cutaneous and pulmonary infections and elevated IgE levels, this syndrome could potentially cause the symptoms described, although it is quite rare.
Churg-Strauss Syndrome (Eosinophilic Granulomatosis with Polyangiitis): A form of vasculitis that can cause asthma, eosinophilia, and various systemic symptoms including skin and lung involvement, making it a rare but possible diagnosis for these symptoms.