Pregabalin for postherpetic itch: a case report

Abstract

Background: Postherpetic itch has not commonly received attention as a complication of herpes zoster because pain predominates over itch in most patients with herpes zoster. Most cases of postherpetic itch are mild; however, cases of severe postherpetic itch reducing quality of life are rare. Case presentation: A 52-year-old woman complained of severe itch in her left pinna and cheek 1 month after the first onset of herpes zoster at the same site. Owing to her scratching, she developed ulcers on her left pinna and cheek. Pregabalin was prescribed, and the itch subsided immediately, with the ulcers disappearing within 1 month. Discussion: Severe itch was thought to be caused by neural injury from herpes zoster. Pregabalin may be a useful treatment option for neuropathic itch induced by herpes zoster.

The relative frequency of pruritus in postherpetic neuralgia patients presenting to the pain clinic and associative factors

“…Although we did not investigate PHP severity, Shimada et al reported a case report of painless severe PHP. [ 6 ] Lee et al reported that the severities of pruritus and pain were significantly correlated in a small number of patients (N = 38). [ 10 ] On the other hand, Ishikawa et al reported no correlation of the visual analog scale score with PHP.…”

“…Gabapentin and pregabalin are effective in patients with PHP or other types of neurogenic pruritus. [ 6 , 21 ] Gabapentin and pregabalin are used to treat neuropathic pain because they act on signal routes that deal with painful stimuli. They also act on signal routes that deal with pruritic stimuli.…”

“…[5] Similar to postherpetic neuralgia (PHN), it can degrade the quality of life of patients and cause injury and disability. [6,7] Although PHN has been extensively studied, few studies have investigated PHP.…”

“…[ 5 ] Similar to postherpetic neuralgia (PHN), it can degrade the quality of life of patients and cause injury and disability. [ 6 , 7 ] Although PHN has been extensively studied, few studies have investigated PHP. The purpose of this study was to investigate PHP incidence and associated factors in patients with PHN.…”

The neuropathic itch: Don't scratch your head too hard!

“…The authors felt its benefit is comparable with radiofrequency or chemical neurolysis of sympathetic ganglion 14 . In another recent study, Shimada et al 15 reported successful use of pregabalin 25 mg daily with prompt relief from the severe itching that was not responding to antihistamines. Ishikawa et al 16 studied PHI in acute, subacute, and chronic stages using Pain Detect Questionnaire and an itch‐intensity score and tried to correlate with neuropathic pain and found that these two sequelae have different mechanisms, needing different therapeutic approaches.…”