Habitual scratching amplifies and perpetuates atopic dermatitis

Staughton, R.C.D.; Bridgett, Christopher; Norén, Peter; Goulding, J. M. R.; Affleck, A.; Walsh, Sarah

doi:10.1111/bjd.19049

Cited by 4 publications

(1 citation statement)

References 6 publications

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“…Brain imaging research has shown atypical brain activation patterns in eczema patients a er pruritic stimulation, suggesting central sensitisation (Misery 2021). Techniques such as habit reversal work on the notion that scratching can become unconscious and widespread beyond the itch itself (Staughton 2020). Such techniques teach patients how to use di erent, less harmful, behaviours where the itch perseveres.…”

Section: Psychological Interventionsmentioning

confidence: 99%

Psychological and educational interventions for managing eczema

Singleton

Hodder

Boyers

et al. 2021

Cochrane Database of Systematic Reviews

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Section: Psychological Interventionsmentioning

confidence: 99%

Psychological and educational interventions for managing eczema

Singleton

Hodder

Boyers

et al. 2021

Cochrane Database of Systematic Reviews

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Educational and psychological interventions for managing atopic dermatitis (eczema)

Singleton,

Hodder,

Almilaji

et al. 2024

Cochrane Database of Systematic Reviews

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Background Atopic dermatitis (eczema), can have a significant impact on well‐being and quality of life for affected people and their families. Standard treatment is avoidance of triggers or irritants and regular application of emollients and topical steroids or calcineurin inhibitors. Thorough physical and psychological assessment is central to good‐quality treatment. Overcoming barriers to provision of holistic treatment in dermatological practice is dependent on evaluation of the efficacy and economics of both psychological and educational interventions in this participant group. This review is based on a previous Cochrane review published in 2014, and now includes adults as well as children. Objectives To assess the clinical outcomes of educational and psychological interventions in children and adults with atopic dermatitis (eczema) and to summarise the availability and principal findings of relevant economic evaluations. Search methods We searched the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, APA PsycINFO and two trials registers up to March 2023. We checked the reference lists of included studies and related systematic reviews for further references to relevant randomised controlled trials (RCTs) and contacted experts in the field to identify additional studies. We searched NHS Economic Evaluation Database, MEDLINE and Embase for economic evaluations on 8 June 2022. Selection criteria Randomised, cluster‐randomised and cross‐over RCTs that assess educational and psychological interventions for treating eczema in children and adults. Data collection and analysis We used standard Cochrane methods, with GRADE to assess the certainty of the evidence for each outcome. Primary outcomes were reduction in disease severity, as measured by clinical signs, patient‐reported symptoms and improvement in health‐related quality‐of‐life (HRQoL) measures. Secondary outcomes were improvement in long‐term control of symptoms, improvement in psychological well‐being, improvement in standard treatment concordance and adverse events. We assessed short‐ (up to 16 weeks after treatment) and long‐term time points (more than 16 weeks). Main results We included 37 trials (6170 participants). Most trials were conducted in high‐income countries (34/37), in outpatient settings (25/37). We judged three trials to be low risk of bias across all domains. Fifteen trials had a high risk of bias in at least one domain, mostly due to bias in measurement of the outcome. Trials assessed interventions compared to standard care. Individual educational interventions may reduce short‐term clinical signs (measured by SCORing Atopic Dermatitis (SCORAD); mean difference (MD) −5.70, 95% confidence interval (CI) −9.39 to −2.01; 1 trial, 30 participants; low‐certainty evidence) but patient‐reported symptoms, HRQoL, long‐term eczema control and psy...

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Pruritus, Prurigo and Lichen Simplex

Ständer,

Yosipovitch

2024

Rook's Textbook of Dermatology

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Chronic pruritus is a common, complex dermatological symptom that has a profound impact on patients and society. It is highly prevelant in the majority of inflammatory skin diseases as well as in bullous autoimmune dermatoses, cutaneous lymphoma, cutaneous drug reactions and ageing skin. Chronic pruritus is also common in non‐dermatological diseases such as advanced stages of chronic kidney disease, hepatobiliary diseases and lymphoproliferative disorders, as well as neuropathies and disorders with psychogenic causes. The pathophysiology is complex and involves many itch mediators and receptors that differ between the diseases, with common neuronal pathways. The majority of types of chronic itch are transmitted by non‐histamnergic nerve fibres. In many inflammatory skin diseases a cross‐talk exists between keratinocytes, the immune system and sensory nerves. The pruritus characteristics of itch and therapy targets may differ between the different aetiological entities, but the impact on quality of life, sleep and psychosocial burden is common to all patients.

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Habitual scratching amplifies and perpetuates atopic dermatitis

Abstract: Linked Article: Gouin and Misery. Br J Dermatol 2020; 182:14–15.

Cited by 4 publications

References 6 publications

Psychological and educational interventions for managing eczema

Psychological and educational interventions for managing eczema

Educational and psychological interventions for managing atopic dermatitis (eczema)

Pruritus, Prurigo and Lichen Simplex

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