Pruritus, pain, and small nerve fiber function in keloids: A controlled study

Lee, Siong See; Yosipovitch, Gil; Chan, Yiong Huak; Goh, Chee Leok

doi:10.1016/j.jaad.2004.07.054

Cited by 146 publications

(98 citation statements)

References 17 publications

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“…They are included in this section for the purpose of clinical classification. Approximately 86% of patients with keloids have itch, which commonly affects the borders of keloid, and pruritus affects 76% of patients with burn lesions [62,63] . EPPER is a rare entity, which may present in the scalp when radiation has been used in this area.…”

Section: Other Skin Lesionsmentioning

confidence: 99%

Scalp Itch: A Systematic Review

Vázquez-Herrera

Sharma

Aleid

et al. 2017

Skin Appendage Disord

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ated with a desire to scratch [1] . Just like skin pruritus, its etiology may be of dermatological or non-dermatological origin. It is common for the dermatologist to encounter patients with no evident cause of scalp pruritus, making it a distressing situation for both the clinician and the patient. The aim of this paper is to review the clinical signs of the most common causes of scalp itch and other less common causes that must be considered in a systematic approach to scalp pruritus. Materials and MethodsWe performed a MEDLINE search through PubMed (1975PubMed ( -2017, using the terms scalp itch and scalp pruritus and included clinical trials, review articles, case series, and case reports to search for the causes of scalp itch. PathophysiologyAlthough various pathogenic etiologies contribute to scalp pruritus, the scalp itself has distinct neuroanatomy and vasculature, specific neuromediators and corresponding receptors, as well as the presence of scalp sebum and microflora, which are all properties that may explain its tendency to be implicated in patients who complain of itch. Keywords Scalp · Itch · Pruritus · Seborrheic dermatitis · Contact dermatitis · Anxiety · Lichen planopilaris · Lice · Pediculosis · Psoriasis · Trichoscopy AbstractScalp itch is a frequent complaint in the dermatological setting. It is common for the dermatologist to encounter patients with no evident cause of scalp pruritus, making it a distressing situation for both the clinician and the patient. The aim of this paper is to propose a systematic approach to scalp itch, which classifies scalp pruritus into two types: (1) with or (2) without dermatological lesions, and presence or absence of hair loss. Also, it is important to think first about the most common causes and then rule out other, less common etiologies. The acronym SCALLP and the five steps for scalp evaluation (listen, look, touch, magnify, and sample) are useful tools to keep in mind for an assertive approach in these patients.

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Section: Other Skin Lesionsmentioning

confidence: 99%

Scalp Itch: A Systematic Review

Vázquez-Herrera

Sharma

Aleid

et al. 2017

Skin Appendage Disord

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“…It leads to aesthetic and physical complaints, causing psychogenic turmoil and severe depression in affected individuals. [5][6][7] Intralesional triamcinolone acetonide (TAC) is considered to be the first line of treatment, however it is effective only against younger keloids, response rate varies from 50% to 100%, and a recurrence rate of 9% to 50% is reported. 8 Local side effects due to TAC include dermal atrophy, telengiectasia and pain at the site of injection.…”

Section: Introductionmentioning

confidence: 99%

A study of verapamil in treatment of keloid

et al. 2018

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Background: Keloid is a common presentation in clinical practice. Symptoms due to keloid are mild, but disfigurement and functional impairment can be severe. It is difficult to treat. Intralesional, injection triamcinolone acetonide, has limited efficacy, causes adverse effects such as local dermal atrophy, telengiectasia and hypopigmentation. Injection verapamil is reported to have similar efficacy, but lesser side effects, and is cheaper. Aim was to study efficacy and adverse effects of intralesional verapamil in treatment of keloid.Methods: An open label study on 25 patients of keloid, either gender, age 11 to 55 years at a medical college hospital. Injection verapamil 2.5 mg/ml was administered intralesionally, at an interval of 3 weeks, for a total of 6 sittings, over a period of 18 weeks. Vancouver scar scale (VSS) was used to assess the improvement. The statistical analysis was done using SPSS version 21.0.Results: Median duration of keloids was 8 months. The mean VSS score before treatment was 7.68 which reduced to 4.28 after treatment. Mean percentage change in VSS score was 46.21%, very highly significant (p<0.001). Physician’s assessment was ‘very good’ in 32.0% and 'excellent' in 8.0%. The complaint of post-procedure pain was present in almost all.Conclusions: Intralesional injection verapamil, gives very good to excellent improvement in 40% of patients of keloid. Post injection pain persists for more than 24 hours. Drug does not cause local dermal atrophy or hypopigmentation.

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“…It has been determined that the excessive deposition of collagen glycosaminoglycan and growth factors (PDGF, TGF-β and FCPI) plays an important role on the deformed appearance of the scar [4,7].…”

Section: Predisposing Factors For Hypertrophic and Keloid Scarsmentioning

confidence: 99%

Verapamil as Alternative Treatment in Hypertrophic and Keloid Scars

Ramos-Gallardo¹,

Delgado-Hernández²,

Cervantes-López³

et al. 2017

J Pigment Disord

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Hypertrophic and keloid scars represent one of the main aesthetic and functional defects in patients after trauma, surgery, or burn. There are different therapeutic approaches used for these conditions, each showing varied results. Verapamil is a selective L-type calcium channel antagonist, which is currently considered as an alternative treatment in hypertrophic and keloid scars. Verapamil reduces the production of extracellular matrix, enhances collagenase secretion, and inhibits Interleukin 6 (IL-6), vascular endothelial growth factor (VEGF) and fibroblast cell proliferation. It also reduces the expression of transforming growth factor beta 1 (TGF-β1), subsequently inducing apoptosis. Verapamil is hereby proposed as an alternative and effective therapy for hypertrophic and keloid scars.

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Pruritus, pain, and small nerve fiber function in keloids: A controlled study

Cited by 146 publications

References 17 publications

Scalp Itch: A Systematic Review

Scalp Itch: A Systematic Review

A study of verapamil in treatment of keloid

Verapamil as Alternative Treatment in Hypertrophic and Keloid Scars

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