How to define chronic pruritus: Symptom or disease?

Ständer, Sonja

doi:10.1111/exd.13953

Cited by 12 publications

(10 citation statements)

References 17 publications

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“…No study exists which analyses how successful a causative therapy is concerning healing and long-term control of CPG .From clinical experiences, additional symptomatic therapies are necessary due to the chronicity of CPG and possible neuronal sensitization in CPG patients [103,104] We suggest thalidomide only in very exceptional cases of CPG that are refractory to safer therapies by physicians who have experience with the drug (based on expert opinion and literature)…”

Section: Strong Consensusmentioning

confidence: 99%

IFSI-guideline on chronic prurigo including prurigo nodularis

Ständer

Pereira

Berger

et al. 2020

Itch

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Chronic prurigo (CPG) is a highly burdensome pruritic disease characterized by chronic itch, a prolonged scratching behavior and the development of localized or generalized hyperkeratotic pruriginous lesions. Neuronal sensitization and the development of an itch-scratch cycle contribute to the augmentation of pruritus and the chronicity of the disease. We provide here the first international guideline for a rational diagnostic and therapeutic approach for CPG. Recommendations are based on available evidence and expert opinion. The diagnosis of CPG is made clinically. A detailed medical history together with laboratory and radiological examinations are advised in order to determine the severity of CPG, identify the underlying origin of the itch and assist in the elaboration of a treatment plan. Therapeutically, it is advised to adopt a multimodal approach, including general strategies to control itch, treatment of the underlying pruritic conditions, and of the pruriginous lesions. Topical (corticosteroids, calcineurin inhibitors, capsaicin) and systemic antipruritic agents (eg, gabapentinoids, immunosuppressants, and opioid modulators) as well

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Section: Strong Consensusmentioning

confidence: 99%

IFSI-guideline on chronic prurigo including prurigo nodularis

Ständer

Pereira

Berger

et al. 2020

Itch

Self Cite

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“…Interestingly, this homogenous profile of pruritus features was recorded, even though patients showed a high variance in skin status, aetiological background and atopic disposition ( Table I ). Common neuronal sensitization mechanisms and the development of an itch-scratch cycle may contribute to similar presentation of pruritus despite heterogeneous underlying clinical features ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

Hand Pruritus: Clinical Profile, Functional Impairment and Disease-related Burden in a Prospective Cohort Study of 395 Patients

Nau

Rau²,

Zeidler³

et al. 2021

Acta Derm Venereol

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Human hands are complex structures essential for a variety of functions in everyday life. This study prospectively investigated the clinical features of hand pruritus and the resulting functional impairment and disease-related burden in 395 patients with chronic pruritus (210 females, median age 59 years). Moderate to very severe hand pruritus was reported by 91.2% of patients, while 79% perceived additional sensory symptoms, such as burning, pain or tingling. A long duration of pruritus occurred in most cases (> 6 months: 71.4%). A considerable proportion of patients showed moderate to severe impairment in the use of their hands (40.2%), performance of daily activities (65.0%) and quality of life (45.2%). Disease severity and burden is particularly high when both the palms and the backs of the hands are affected, and when pain is present simultaneously. Pruritus located on the hands is impairing and burdensome due to the functional relevance of the hands in everyday life.

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“…Chronic itch (CI) is defined as itching lasting 6 weeks or more. It is commonly associated with many dermatological and systemic diseases, such as diabetes mellitus, hypothyroidism, chronic hepatobiliary conditions, malignancies, and end-stage renal disease (ESRD) [ 1 , 2 ]. The term “uraemic pruritus” is widely used in the literature.…”

Section: Introductionmentioning

confidence: 99%

Serum Level of Protein-Bound Uraemic Toxins in Haemodialysis Patients with Chronic Kidney Disease-Associated Pruritus: Myths and Facts

Świerczyńska-Mróz

Nowicka-Suszko

Fleszar

et al. 2023

JCM

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Recent studies place great importance on Protein-Bound Uraemic Toxins (PBUT) in the context of etiopathogenesis of chronic kidney disease-associated pruritus (CKD-aP). This study aimed to investigate the possible contribution of free and total Indoxyl Sulfate (IS) and p-Cresol Sulfate (PCS) to the cause of CKD-aP. Group A included 64 patients on maintenance haemodialysis (HD) with CKD-aP. Group B included 62 patients on maintenance HD that did not report CKD-aP, and group C included 50 healthy controls. Pruritus severity was assessed using a Numerical Rating Scale (NRS). Moreover, other tools like UP-Dial, ItchyQoL, and the 4-Item Itch Questionnaire evaluating CKD-aP were completed by the patients. The serum levels of free and total IS and PCS concentrations were measured using the Ultra Performance Liquid Chromatography System. No significant difference in the serum level of free and total IS, or PCS, was observed between the patients who reported CKD-aP and those without pruritus. Moreover, there was no correlation between serum IS or PCS levels and the severity of the itch. Our study does not support earlier findings about higher levels of IS and PCS in patients reporting CKD-aP. Further studies will be needed to investigate these discrepancies as well as to understand the cause of CKD-aP.

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How to define chronic pruritus: Symptom or disease?

Cited by 12 publications

References 17 publications

IFSI-guideline on chronic prurigo including prurigo nodularis

IFSI-guideline on chronic prurigo including prurigo nodularis

Hand Pruritus: Clinical Profile, Functional Impairment and Disease-related Burden in a Prospective Cohort Study of 395 Patients

Serum Level of Protein-Bound Uraemic Toxins in Haemodialysis Patients with Chronic Kidney Disease-Associated Pruritus: Myths and Facts

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