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International Journal of Molecular... Dec 2020Pruritus is a relatively common symptom that anyone can experience at any point in their life and is more common in the elderly. Pruritus in elderly can be defined as... (Review)
Review
Pruritus is a relatively common symptom that anyone can experience at any point in their life and is more common in the elderly. Pruritus in elderly can be defined as chronic pruritus in a person over 65 years old. The pathophysiology of pruritus in elderly is still unclear, and the quality of life is reduced. Generally, itch can be clinically classified into six types: Itch caused by systemic diseases, itch caused by skin diseases, neuropathic pruritus, psychogenic pruritus, pruritus with multiple factors, and from unknown causes. Senile pruritus can be defined as a chronic pruritus of unknown origin in elderly people. Various neuronal mediators, signaling mechanisms at neuronal terminals, central and peripheral neurotransmission pathways, and neuronal sensitizations are included in the processes causing itch. A variety of therapies are used and several novel drugs are being developed to relieve itch, including systemic and topical treatments.
Topics: Aged; Disease Management; Humans; Pruritus; Quality of Life
PubMed: 33375325
DOI: 10.3390/ijms22010174 -
BioMed Research International 2018Pruritus, the most common cutaneous symptom, is widely seen in many skin complaints. It is an uncomfortable feeling on the skin and sometimes impairs patients' quality... (Review)
Review
Pruritus, the most common cutaneous symptom, is widely seen in many skin complaints. It is an uncomfortable feeling on the skin and sometimes impairs patients' quality of life. At present, the specific mechanism of pruritus still remains unclear. Antihistamines, which are usually used to relieve pruritus, ineffectively work in some patients with itching. Recent evidence has suggested that, apart from histamine, many mediators and signaling pathways are involved in the pathogenesis of pruritus. Various therapeutic options for itching correspondingly have been developed. In this review, we summarize the updated pathogenesis and therapeutic strategies for pruritus.
Topics: Humans; Medicine, Chinese Traditional; Pruritus; Signal Transduction
PubMed: 29850592
DOI: 10.1155/2018/9625936 -
Acta Dermato-venereologica Apr 2019Pruritus is a frequent symptom in medicine. Population-based studies show that every 5th person in the general population has suffered from chronic pruritus at least...
Pruritus is a frequent symptom in medicine. Population-based studies show that every 5th person in the general population has suffered from chronic pruritus at least once in the lifetime with a 12-month incidence of 7%. In patient populations its frequency is much higher depending on the underlying cause, ranging from around 25% in haemodialysis patients to 100% in skin diseases such as urticaria and atopic dermatitis (AD). Pruritus may be the result of a dermatological or non-dermatological disease. Especially in non-diseased skin it may be caused by systemic, neurological or psychiatric diseases, as well as being a side effect of medications. In a number of cases chronic pruritus may be of multifactorial origin. Pruritus needs a precise diagnostic work-up. Management of chronic pruritus comprises treatment of the underlying disease and topical treatment modalities, including symptomatic antipruritic treatment, ultraviolet phototherapy and systemic treatment. Treating chronic pruritus needs to be targeted, multimodal and performed in a step-wise procedure requiring an interdisciplinary approach. We present the updated and consensus based (S2k) European guideline on chronic pruritus by a team of European pruritus experts from different disciplines. This version is an updated version of the guideline that was published in 2012 and updated in 2014 (www.euroderm.org).
Topics: Chronic Disease; Dermatology; Europe; Humans; Incidence; Predictive Value of Tests; Pruritus; Risk Factors; Treatment Outcome
PubMed: 30931482
DOI: 10.2340/00015555-3164 -
Journal Der Deutschen Dermatologischen... Oct 2022Pruritus is a cross-disciplinary leading symptom of numerous diseases and represents an interdisciplinary diagnostic and therapeutic challenge. In contrast to acute...
Pruritus is a cross-disciplinary leading symptom of numerous diseases and represents an interdisciplinary diagnostic and therapeutic challenge. In contrast to acute pruritus, chronic pruritus (CP) is a symptom of various diseases that is usually difficult to treat. Scratching and the development of scratch-associated skin lesions can alter the original skin status. In the presence of an itch-scratch-cycle, even secondary diseases such as chronic prurigo can develop. Chronic pruritus leads to considerable subjective suffering of those affected, which can result in restrictions on the health-related quality of life such as sleep disturbances, anxiety, depressiveness, experience of stigmatization and/or social withdrawal up to clinically relevant psychic comorbidities. Medical care of patients should therefore include (a) interdisciplinary diagnosis and therapy of the triggering underlying disease, (b) therapy of the secondary symptoms of pruritus (dermatological therapy, sleep promotion, in the case of an accompanying or underlying psychological or psychosomatic disease an appropriate psychological-psychotherapeutic treatment) and (c) symptomatic antipruritic therapy. The aim of this interdisciplinary guideline is to define and standardize the therapeutic procedure as well as the interdisciplinary diagnosis of CP. This is the short version of the updated S2k-guideline for chronic pruritus. The long version can be found at www.awmf.org.
Topics: Humans; Antipruritics; Quality of Life; Chronic Disease; Pruritus; Prurigo
PubMed: 36252071
DOI: 10.1111/ddg.14830 -
Anais Brasileiros de Dermatologia 2022This review is focused on updating knowledge about cholestatic pruritus. It summarizes clinical-epidemiological characteristics, pathophysiology, diagnostic approach,... (Review)
Review
This review is focused on updating knowledge about cholestatic pruritus. It summarizes clinical-epidemiological characteristics, pathophysiology, diagnostic approach, and evidence-based therapeutic recommendations regarding this form of pruritus. Pruritus is a frequent symptom that accompanies several liver diseases, particularly cholestatic ones. The symptom may be mild and tolerable, but it can also dramatically reduce the quality of life. Although the exact pathophysiology of this form of pruritus remains unclear, current evidence supports a mixed origin. It is extremely important for dermatologists to have knowledge about cholestatic pruritus since they are usually the first physicians to be sought by the patient when they experience the symptom. In the absence of specific dermatological alterations, cholestasis must always be considered as a possible cause of pruritus. In addition to allowing an adequate diagnosis, a better pathophysiological understanding of hepatic pruritus provides the identification of new therapeutic targets and, consequently, optimization of the approach in patients with this condition.
Topics: Cholestasis; Humans; Pruritus; Quality of Life
PubMed: 35279351
DOI: 10.1016/j.abd.2021.06.007 -
Clinics in Dermatology 2019Pruritus, as one of the most common clinical manifestations in medicine, has been recognized for many centuries. Defined as an unpleasant sensation resulting in the need... (Review)
Review
Pruritus, as one of the most common clinical manifestations in medicine, has been recognized for many centuries. Defined as an unpleasant sensation resulting in the need to scratch, it is divided into acute and chronic stages, based on the duration of the clinical manifestation. Classically, pruritus is associated with cutaneous disorders; however, it may also accompany various systemic disorders, including renal, hepatic, hematologic, or oncologic, and be the first or solitary manifestation of an underlying systemic disease. Additionally, the clinical manifestation may occur as an adverse reaction to drug administration. The pathogenesis of itch is multifactorial, involving various neuromediators and cytokines, with a prominent role of peripheral and central nervous system in its development. Based on an underlying disorder, the affected patients present different clinical patterns of pruritus. Diagnostic approach is based on detailed history taking and physical examination. Frequently, additional diagnostic measures, including laboratory or imaging tests, are performed, especially when the cause of pruritus is unknown. Pruritus remains a challenging clinical manifestation with a significant importance for physicians managing systemic disorders.
Topics: Acute Disease; Chronic Disease; Cytokines; Humans; Pruritus; Skin Diseases
PubMed: 31864443
DOI: 10.1016/j.clindermatol.2019.07.031 -
Revista Alergia Mexico (Tecamachalco,... 2019Chronic pruritus is defined as an unpleasant sensation on the skin that causes scratching and lasts more than six weeks. This symptom may be a manifestation of a... (Review)
Review
Chronic pruritus is defined as an unpleasant sensation on the skin that causes scratching and lasts more than six weeks. This symptom may be a manifestation of a cutaneous or systemic disease and it jeopardizes the patients' quality of life, constantly altering their sleep and daily activities. The pathophysiology is complex and it includes multiple mediators and their respective receptors which, through different signaling pathways, carry information through type C nerve fibers towards the thalamus; from where it is distributed to various areas of the cerebral cortex. The understanding of these mechanisms has made it possible to identify potential therapeutic targets and the development of molecules that are increasingly more effective and safer for patients. The present review aims to give a vision of the diagnostic and therapeutic handling of patients with chronic pruritus.
Topics: Chronic Disease; Decision Trees; Humans; Pruritus
PubMed: 31013410
DOI: 10.29262/ram.v66i1.345 -
Der Nervenarzt Feb 2023Neuropathic pruritus is a previously neglected symptom of a wide range of neurological diseases. Peripheral nerve or root compression syndromes, space-occupying... (Review)
Review
Neuropathic pruritus is a previously neglected symptom of a wide range of neurological diseases. Peripheral nerve or root compression syndromes, space-occupying lesions of the central nervous system, chronic inflammatory neurological diseases and polyneuropathy can cause neuropathic pruritus. Even when the identification of the underlying neurological disease is successful, a direct causal treatment is not always possible, hence an effective symptomatic treatment remains the only therapeutic option. The purpose of this review article is to present the current literature on various therapeutic agents and options in the treatment of neuropathic pruritus.
Topics: Humans; Pruritus; Peripheral Nervous System Diseases; Central Nervous System; Polyneuropathies
PubMed: 35951052
DOI: 10.1007/s00115-022-01369-0 -
Nature Reviews. Neurology Jul 2014Pruritus, also known as itch, is a very common, unpleasant sensation that elicits an urge to scratch. Its origin is not always in the skin, and neuropathic itch that is... (Review)
Review
Pruritus, also known as itch, is a very common, unpleasant sensation that elicits an urge to scratch. Its origin is not always in the skin, and neuropathic itch that is caused by neuronal or glial damage is common, but poorly understood by both dermatologists and neurologists. Although pruritus has not been considered as serious a symptom as pain, it is difficult to treat and--if chronic--can severely impair quality of life. Neuropathic itch is often associated with other clinical symptoms, most commonly neuropathic pain, and hypersensitization to stimuli is present in both pruritus and pain of neuropathic origin. The shared aetiology can aid in finding suitable treatment for itch in some cases, but more detailed knowledge of the mechanisms of itch, along with standardized, well-controlled trials, is needed. Pruritus research is an emerging but currently very active field, and our understanding of this sensation is rapidly increasing. Here, we review new discoveries regarding the role of the nervous system and the contribution of different pathways in pruritus, discuss the different aetiologies of neuropathic itch, and outline currently available and potential strategies for managing neuropathic pruritus.
Topics: Central Nervous System; Humans; Magnetic Resonance Imaging; Nervous System Diseases; Pruritus
PubMed: 24912513
DOI: 10.1038/nrneurol.2014.99 -
Actas Dermo-sifiliograficas Jun 2023Pruritus is the most common symptom of dermatologic and systemic diseases. The diagnosis of pruritus is clinical, although additional tests may be necessary to identify... (Review)
Review
Pruritus is the most common symptom of dermatologic and systemic diseases. The diagnosis of pruritus is clinical, although additional tests may be necessary to identify or confirm the cause. Translational medicine has led to the discovery of new mediators of itch, or pruritogens, as well as new receptors. Knowing how to properly recognize the main pathway that mediates itch in each patient is the key to successful treatment. Although the histaminergic pathway predominates in conditions like urticaria or drug-induced pruritus, it is the nonhistaminergic pathway that predominates in nearly all other skin diseases covered in this review. Part 1 of this 2-part review discusses the classification of pruritus, additional testing, the pathophysiology of itch and the pruritogens implicated (including cytokines and other molecules), and central sensitization to itch.
Topics: Humans; Dermatology; Pruritus; Skin Diseases; Cytokines
PubMed: 36965771
DOI: 10.1016/j.ad.2023.03.003