Neuropathic pruritus

Abstract

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.

Kleinfaserneuropathie als mögliche Ursache für chronischen Pruritus

“…Systemische Erkrankungen, die zu einem generalisierten Schaden der kleinen epidermalen unmyelinisierten C-Fasern führen, können neben weiteren neurologischen Symptomen (Schmerz, Brennen, Kribbeln) mit Pruritus einhergehen [17] …”

Le prurit : des avancées physiopathologiques considérables

“…Il existe, d'ailleurs, un chevauchement entre pruricepteurs et nocicepteurs [9], ce qui permet de comprendre pourquoi un prurit neuropathique est rarement pur. 2 Technique invasive qui permet l'enregistrement de fibres nociceptives individuelles. 3 L' iontophorèse (IP) consiste à faire pénétrer au niveau de la peau une substance ionisée à l'aide d'un courant électrique.…”

“…Les agonistes des récepteurs kappa des opiacés, essentiellement la naltrexone pour l'instant, semblent promis à un avenir inté-ressant. La gabapentine ou la prégabaline s'imposent comme le traitement de réfé-rence des prurits neuropathiques [2]. La découverte de nouveaux récepteurs impliqués dans le prurit constitue autant de …”

“…< ou maladies générales (hémopathies, maladies endocriniennes, etc.). Il peut être induit par des agents exogènes (produits chimiques, médi-caments), ou avoir une origine uniquement neurogène [2] ou psychogène, et se présente sous forme aiguë ou chronique. L'appréciation de son intensité est difficile.…”

Microglia are Involved in Pruritus Induced by DNFB via the CX3CR1/p38 MAPK Pathway

“…Pruritus, also known as itch, is a common, sometimes unpleasant sensation that elicits an urge to scratch [1]. Itch can be categorized as either acute or chronic, depending on its persistence [2].…”