Objective scratch monitor evaluation of the effect of an antihistamine on nocturnal scratching in atopic dermatitis

Endo, Kaoru; Sano, Hozumi; Fukuzumi, Takayuki; Adachi, Jun; Aoki, Toshiyuki

doi:10.1016/s0923-1811(99)00048-1

Cited by 13 publications

(14 citation statements)

References 22 publications

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“…For adults, O’Donoghue et al [ 43 ] reported that sedating antihistamines (e.g., hydroxyzine, diphenhydramine) are often beneficial in patients who suffer from exacerbations of pruritus at night. Furthermore, Endo et al [ 44 ] demonstrated that azelastine hydrochloride, a nonsedating antihistamine, can alleviate nocturnal scratching and sleep disturbance in the early period of sleep of patients, especially in patients with a serum immunoglobulin (Ig) E ≥1000 IU/ml. However, ‘sleep time’ or ‘pre-sleep’ time did not differ significantly.…”

Section: Resultsmentioning

confidence: 99%

Frequency and Management of Sleep Disturbance in Adults with Atopic Dermatitis: A Systematic Review

Jeon

Yan

Nakamura

et al. 2017

Dermatol Ther (Heidelb)

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IntroductionIntense nocturnal pruritus as well as the complex pathophysiology of atopic dermatitis (AD) can severely affect sleep and become a major factor in negatively impacting quality of life in adults. However, much of the literature on sleep disturbance in AD patients is on the pediatric population, and it is not well studied in adults. Furthermore, limited studies are available to guide effective management of sleep disturbance in AD in general. We review the literature to present the studies that have investigated the relationship between AD and its effect on sleep in adults and provide an approach for clinicians caring for this population.MethodsA systematic literature search was conducted through the PubMed and EMBASE databases using the search terms “atopic dermatitis” OR “eczema” AND “sleep.” The articles generated by the search and their references were reviewed.ResultsA high prevalence of sleep disturbance is experienced by adults with AD. The likelihood of sleep disturbance is much higher in patients with AD compared to those without AD. Sleep disturbance appears to worsen with AD severity. Pruritus and scratching appear to be large contributors to sleep disturbance in adult patients with AD.ConclusionIt is important that clinicians evaluate the severity of AD and ask general questions about itching, sleep, impact on daily activities, and persistence of disease during each patient visit and follow-up with the complaint of sleep disturbance. Management of sleep disturbance in AD should focus on adequate disease control of AD as well as possible medical interventions to help improve sleep. The pathophysiology of sleep disturbance in AD is extremely complex, and further research is needed to better understand the interplay of the immune system, circadian rhythm, and environmental factors implicated in both AD and sleep.

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Section: Resultsmentioning

confidence: 99%

Frequency and Management of Sleep Disturbance in Adults with Atopic Dermatitis: A Systematic Review

Jeon

Yan

Nakamura

et al. 2017

Dermatol Ther (Heidelb)

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“…Azelastine, an H 1 histamine receptor antagonist that inhibits the action and production of LTB 4 (9), suppresses nocturnal scratching in patients with atopic dermatitis after 3 days of administration (10). Subjective scores for pruritus have been reported to be decreased in five of six patients with atopic dermatitis after 6 weeks of zileuton administration (47).…”

Section: Discussionmentioning

confidence: 99%

“…LTB 4 is increased in the lesional skin of patients with atopic dermatitis (7,8). Azelastine, an H 1 histamine receptor antagonist that inhibits the action and production of LTB 4 (9), suppresses itch in atopic dermatitis patients (10). In animal models of itch, LTB 4 elicits scratching, an itch‐related response (11), and is involved in itch‐related responses to intradermal injections of substance P (12) and nociceptin (13), and allergies such as passive cutaneous anaphylaxis and contact dermatitis (14,15).…”

Section: Introductionmentioning

confidence: 99%

Involvement of leukotriene B4 in spontaneous itch-related behaviour in NC mice with atopic dermatitis-like skin lesions

Andoh

Haza

Saito

et al. 2011

Experimental Dermatology

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To elucidate the mechanisms of severe itch in atopic dermatitis, we investigated the role of leukotriene B(4) , a potent itch mediator, in spontaneous itch-related behaviour in NC mice with atopic dermatitis-like skin lesions. Topical application of the BLT leukotriene B(4) receptor antagonist ONO-4057 inhibited spontaneous itch-related behaviour. The concentration of leukotriene B(4) was significantly increased in the lesional skin. The expression levels of 5-lipoxygenase were also elevated in the lesional skin, yet present throughout the epidermis of both healthy and lesional skin. These results suggest a role for leukotriene B(4) in chronic dermatitis-related itch. Sphingosylphosphorylcholine (SPC) was increased in the epidermis of the lesional skin. Moreover, intradermal injection of SPC elicited itch-related behaviours in healthy mice. Because SPC induces itch-related responses through the production of leukotriene B(4) in keratinocytes (J Invest Dermatol, 129, 2009, 2854), these results suggest that an increase in SPC induces leukotriene B(4) -mediated itching in chronic dermatitis. BLT1 receptor and 5-lipoxygenase in the skin may be effective pharmacological targets for the treatment of itch in atopic dermatitis.

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“…Systemic anti-allergy drugs such as antihistamines are commonly recommended despite the fact that their use is controversial. This is because the clinical relevance of either sedative or non-sedative antihistamines is yet to be conclusively demonstrated in AD patients [1, 4, 6, 7, 8, 9, 10, 11]. It is still widely believed that the central sedative effect of earlier-generation sedative antihistamines (e.g.…”

Section: Introductionmentioning

confidence: 99%

Chlorpheniramine Is No More Effective than Placebo in Relieving the Symptoms of Childhood Atopic Dermatitis with a Nocturnal Itching and Scratching Component

Munday

Bloomfield²,

Goldman

et al. 2002

Dermatology

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Background: Childhood atopic dermatitis (AD) is a common disorder affecting 15% of children aged over 18 months. AD is associated with intense nocturnal itching. The central sedative effect of antihistamines is thought to be useful in interrupting the itching cycle and may prevent exacerbations. Objective: A multi-centred, double-blind, placebo-controlled study was carried out in 155 children to evaluate chlorpheniramine in alleviating symptoms of AD. Methods: Assessments were carried out over a 4-week study period consisting of 3 visits to out-patient clinics. During the visits the severity of AD and itching was rated using a series of visual analogue scale (VAS) and 5-point rating scales. Results: The use of chlorpheniramine resulted in no greater alleviation of AD symptoms than placebo. Conclusions: The findings contradict conventional wisdom that the sedative effect of earlier-generation antihistamines alleviates symptoms of AD. The study also indicates that the use of antihistamines in AD does not affect the amounts of topical treatment used over the short term.

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Objective scratch monitor evaluation of the effect of an antihistamine on nocturnal scratching in atopic dermatitis

Cited by 13 publications

References 22 publications

Frequency and Management of Sleep Disturbance in Adults with Atopic Dermatitis: A Systematic Review

Frequency and Management of Sleep Disturbance in Adults with Atopic Dermatitis: A Systematic Review

Involvement of leukotriene B4 in spontaneous itch-related behaviour in NC mice with atopic dermatitis-like skin lesions

Chlorpheniramine Is No More Effective than Placebo in Relieving the Symptoms of Childhood Atopic Dermatitis with a Nocturnal Itching and Scratching Component

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