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Zhonghua Shao Shang Yu Chuang Mian Xiu... Jul 2023Pruritus is one of the common symptoms after burn injury, which seriously affects the wound healing and quality of life of burn patients, but its diagnosis and treatment... (Review)
Review
Pruritus is one of the common symptoms after burn injury, which seriously affects the wound healing and quality of life of burn patients, but its diagnosis and treatment are often neglected. The pathophysiological mechanism of post-burn pruritus has not been elucidated, and it is currently believed that post-burn pruritus is caused by the neuropathic factors. In addition, there is no consensus on the standard evaluation methods and treatment protocols for post-burn pruritus. This paper reviewed the research advances on the pathophysiological mechanism, disease evaluation, and treatment of post-burn pruritus.
Topics: Humans; Pruritus; Quality of Life; Wound Healing
PubMed: 37805700
DOI: 10.3760/cma.j.cn501225-20221018-00457 -
Journal of Gastroenterology and... 1993The pathogenesis of pruritus of cholestasis remains unclear. Bile salts do not appear to be the sole prurogens in cholestasis. Histaminergic pathways may be involved,... (Review)
Review
The pathogenesis of pruritus of cholestasis remains unclear. Bile salts do not appear to be the sole prurogens in cholestasis. Histaminergic pathways may be involved, and central opiate receptor processes seem much more important than has previously been recognized. The therapeutic options for relief of cholestatic pruritus are summarized in Table 2. Resins such as cholestyramine are the first line of therapy. In cases where cholestyramine has failed, rifampicin and antihistamines may be beneficial. Opiate antagonists hold great potential if opioid withdrawal-like syndromes can be avoided. Ursodeoxycholic acid and methotrexate have an advantage in not only relieving pruritus but also potentially retarding disease progression in PBC and PSC, respectively, although this remains to be proved. Other agents such as EPO and SAMe remain experimental and require further study to clarify their effectiveness before they can be recommended.
Topics: Cholestasis; Humans; Pruritus
PubMed: 8471755
DOI: 10.1111/j.1440-1746.1993.tb01510.x -
Journal of Nephrology 2008Skin itching (pruritus) affects 50%-90% of patients undergoing peritoneal dialysis or hemodialysis and the symptoms range from localized and mild to generalized and... (Review)
Review
Skin itching (pruritus) affects 50%-90% of patients undergoing peritoneal dialysis or hemodialysis and the symptoms range from localized and mild to generalized and severe. Among the dermatological abnormalities associated with end-stage renal disease, pruritus is the most prevalent. Of all systemic disorders, uremia is the most important cause of pruritus. The mechanism underlying uremic pruritus is poorly understood: secondary hyperparathyroidism, divalent-ion abnormalities, histamine, allergic sensitization, proliferation of skin mast cells, iron-deficiency anemia, neuropathy and neurological changes, or a combination of these have been hypothesized. Severe pruritus not only affects the quality of life but is also associated with poor outcome in chronic hemodialysis patients. No specific, effective treatment is currently available for uremic pruritus. Further studies are necessary to evaluate the long-term efficacy and safety of a novel kappa-opioid agonist, nalfurafine. Early diagnosis and treatment of uremic pruritus focusing on general strategies that include the optimization of dialysis dose, erythropoiesis-stimulating agents, and management of secondary hyperparathyroidism is recommended.
Topics: Humans; Pruritus; Renal Dialysis; Uremia
PubMed: 18446709
DOI: No ID Found -
Dermatologic Therapy 2010Chronic itch could be a presenting sign of malignancy. Pruritus of lymphoma is the common prototype of paraneoplastic itch and can precede other clinical signs by weeks... (Review)
Review
Chronic itch could be a presenting sign of malignancy. Pruritus of lymphoma is the common prototype of paraneoplastic itch and can precede other clinical signs by weeks and months. Paraneoplastic pruritus has also been associated with solid tumors and is an important clinical symptom in paraneoplastic skin diseases such as erythroderma, Grovers disease, malignant acanthosis nigricans, generalized granuloma annulare, Bazex syndrome, and dermatomyositis. In any case with high index of suspicion a thorough work-up is required. This review highlights the association between itch and malignancy and presents new findings related to pathophysiological mechanisms and the treatment of itch associated with malignancy. Combinative therapies reducing itch sensitization and transmission using selective serotonin and neuroepinephrine reuptake inhibitors, Kappa opioids, and neuroleptics are of prime importance in reducing this bothersome symptom.
Topics: Antipruritics; Chronic Disease; Humans; Paraneoplastic Syndromes; Pruritus; Treatment Outcome
PubMed: 21054705
DOI: 10.1111/j.1529-8019.2010.01366.x -
Journal of the American Academy of... Jan 2022Itch, or pruritus, is the uncomfortable sensation underlying the desire to scratch. Itch is a very common complaint in the general population that can result from... (Review)
Review
Itch, or pruritus, is the uncomfortable sensation underlying the desire to scratch. Itch is a very common complaint in the general population that can result from dermatologic, systemic (eg, renal, hepatobiliary, endocrine), paraneoplastic, neuropathic, and psychogenic etiologies. Chronic itch is associated with significant sleep disturbances and profoundly reduces overall quality of life. Certain populations, including elderly and African Americans, are at increased risk of experiencing heightened burden of itch. Because of the variable clinical presentation and wide-ranging etiologies, itch presents a challenge for clinicians. The initial evaluation should include a complete blood count, with differential, hepatic, renal, and thyroid function testing along with diabetes screening. Further testing should be guided by history and physical examination findings. There should be a heightened concern for underlying malignancy in individuals older than 60 years of age who have a history of liver disease and diffuse itch less than 12 months of duration. For individuals with chronic pruritus of unknown origin, increased blood eosinophils may serve as a biomarker of T helper cell type 2 polarization and response to immunomodulator therapies. In this first part of a 2-part continuing medical education series, we describe the broader epidemiology and specific conditions associated with itch and the clinical presentation and diagnostic workup for patients with itch.
Topics: Aged; Combined Modality Therapy; Humans; Infant; Neoplasms; Peripheral Nervous System Diseases; Pruritus; Quality of Life
PubMed: 34428534
DOI: 10.1016/j.jaad.2021.07.076 -
Clinical and Experimental Dermatology Nov 1999Itch is one of the major symptoms of skin disease although it remains poorly studied. Little is known about its mediators or the neurological processes involved in... (Review)
Review
Itch is one of the major symptoms of skin disease although it remains poorly studied. Little is known about its mediators or the neurological processes involved in either the detection of an itch stimulus or the induction of the main response to itch, scratch. This lack of knowledge may be due to the subjective nature of the sensation itself and the related difficulties in quantifying it, and is compounded by the absence of a convincing animal model. Defining itch as that sensation which provokes the desire to scratch provides two approaches to measurement, that of itch itself, and the behavioural response, scratch. The measurement of itch itself traditionally involves the use of questionnaires or visual analogue scale, both of which rely on the dubious assumption that the subject is able to relate their experiences accurately. By contrast experimental induction of itch and measurement of areas of allokinesis around application sites may provide a more reliable and repeatable method of itch quantification. Recent advances in two areas that may prove relevant are discussed: new technological improvements in movement meters and compatible software; and some recently described animal models.
Topics: Humans; Neural Conduction; Pruritus; Sensation; Signal Transduction
PubMed: 10606957
DOI: 10.1046/j.1365-2230.1999.00541.x -
Der Hautarzt; Zeitschrift Fur... May 2006
Topics: Humans; Pruritus; Skin
PubMed: 16534628
DOI: 10.1007/s00105-006-1135-6 -
La Revue Du Praticien Dec 2017Pruritus of the elderly. Pruritus is defined as an unpleasant sensation that causes the need for scratching. In the elderly, it is frequently encountered. As in the...
Pruritus of the elderly. Pruritus is defined as an unpleasant sensation that causes the need for scratching. In the elderly, it is frequently encountered. As in the younger subject, it is generally linked to a skin disease and the diagnosis generally allows the treatment. A disease is nevertheless much more frequent: the bullous pemphigoid. More often than in younger patients, pruritus is sine materia. Many etiologies are then possible. The first reflex is then to look for a side effect of drug(s). Finally, pruritus is often idiopathic; this is called senile pruritus because it is probably related to aging.
Topics: Aged; Humans; Pruritus
PubMed: 30512604
DOI: No ID Found -
Drug News & Perspectives Dec 2008Pruritus (itch) is an unpleasant sensation inducing the desire to scratch. Chronic pruritus (>6 weeks' duration) is a major and distressing symptom of many diseases of... (Review)
Review
Pruritus (itch) is an unpleasant sensation inducing the desire to scratch. Chronic pruritus (>6 weeks' duration) is a major and distressing symptom of many diseases of dermatological, systemic, neurological or psychogenic origin. Frequently, the underlying cause of pruritus cannot be identified and causal therapy is not possible. Furthermore, chronic pruritus is frequently refractory to conventional symptomatic therapies. Recent research has revealed new neuronal mechanisms in the skin and brain, suggesting novel therapeutic targets. The efficacy of the corresponding innovative therapies has been proven in recent studies and case series. For example, topical or systemic application of specific agonists such as cannabinoids or calcineurin inhibitors can influence neuroreceptors on sensory nerve fibers of the skin and suppress pruritus. Itch-selective neurons in the dorsal horn of the spinal cord can be targeted to inhibit the transmission of pruritus to the somatosensory cortex. Anticonvulsants, antidepressants and micro-opioid receptor antagonists interfere with the sensation of pruritus in the central nervous system. Chronic pruritus of any origin leads to considerable psychosocial burden and impairs quality of life. Psychoeducational interventions, stress training, training in social competence and relaxation techniques are therefore important elements in the treatment of chronic pruritus. Increasing knowledge of the neurobiology of chronic pruritus offers new therapeutic strategies. Currently, several clinical trials are investigating the efficacy of new substances addressing neuroreceptors and cytokines in the skin and central nervous system. The present review aims to provide an overview of current neurophysiological and neurochemical therapeutic models in chronic pruritus.
Topics: Animals; Antipruritics; Brain; Calcineurin Inhibitors; Cannabinoids; Central Nervous System Agents; Chronic Disease; Dermatologic Agents; Humans; Pruritus; Skin; Stress, Psychological
PubMed: 19221635
DOI: 10.1358/dnp.2008.21.10.1314057 -
Dermatologic Therapy Mar 2022
Topics: Antibodies, Monoclonal, Humanized; Humans; Pruritus
PubMed: 34981593
DOI: 10.1111/dth.15296