Understanding Pruritus in Systemic Disease

Krajnik, Małgorzata; Żylicz, Zbigniew

doi:10.1016/s0885-3924(00)00256-6

Cited by 134 publications

(89 citation statements)

References 135 publications

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“…It can be a physiologic response against harmful agents such as parasites or a symptom of a disease (1,2). Many skin and systemic diseases such as renal insufficiency, cholestasis, Hodgkin's lymphoma, polycythemia vera, and solid tumors cause pruritus that in most cases required drug therapy (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Role of Pregabalin in Management of Pruritus: A Literature Review

Foroutan

Nikvarz

2016

J Pharm Pharm Sci

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-Purpose. Pruritus can be one of the distressing symptoms of many dermatologic, systemic, neurologic or psychiatric disorders. In each case, the origin of itch is in the skin and/or the nervous system. Involvement of the nervous system causes neurogenic, psychogenic or neuropathic itch. Itch sensation is transferred to the central nervous system via unmyelinated C-type nerve fibers, and many mediators and receptors engage in the its induction and transmission. Also it has been demonstrated that there are similarities and interactions between neurotransmitters and pathways of pain and itch sensation. Hence, effective drugs in reducing the neuropathic pain such as pregabalin have been studied and used in the management of different itchy conditions. In this narrative review we considered the available published papers dealing with the antipruritic effects of pregabalin. Results of studies conducted in uremic patients show that pregabalin is an effective option in reducing uremic pruritus especially in those who have not responded to antihistamines and topical moisturizers. Data about the effects of pregabalin on other itchy conditions are very limited; however results of the available studies show beneficial effects of this drug in burn patients with more than 5% involvement of the total body surface area, in prurigo nodularis, and in chronic and idiopathic itch. One considerable issue is that the therapeutic effects of pregabalin on uremic pruritus and post burn itch may appear more rapidly than its effects in the other conditions (1-2 weeks vs > 4 weeks). The most reported adverse effects of pregabalin are sedation, dizziness and drowsiness. Whether pregablin can be unequivocally considered as an effective and reasonable choice in the management of pruritus with different causes is a question that should be answered through large scale randomized controlled studies.

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Section: Introductionmentioning

confidence: 99%

Role of Pregabalin in Management of Pruritus: A Literature Review

Foroutan

Nikvarz

2016

J Pharm Pharm Sci

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“…Mycosis fungoides is the most common form of cutaneous T cell lymphoma and represents approximately 50% of all lymphomas arising primarily in the skin [1,2]. Cutaneous lesions can be divided morphologically into patches, plaques, and tumors, and this clinical morphology is used to classify the disease into three clinical stages accordingly [2].…”

Section: Discussionmentioning

confidence: 99%

“…Pruritus is a prominent symptom of many skin diseases and is also frequently present in hematological malignancies such as Hodgkin disease and occasionally in chronic lymphocytic leukemia and mycosis fungoides (MF) [1,2]. Hepatobiliary malignancies are also a rare cause.…”

Section: Introductionmentioning

confidence: 99%

Invisible mycosis fungoides—Not to be missed in chronic pruritus

2016

Journal of the American Academy of Dermatology

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“…Itch impulses are transmitted from the ipsilateral dorsal horn of the spinal cord through these itch-specific C-fibres to synapse with itch-specific secondary neurons. The secondary neurons travel within the opposite anterolateral spinothalamic tract to the thalamus before reaching the somatosensory cortex (12). Free nerve endings of cutaneous sensory C-fibres serve as receptors for pruritus (known as pruriceptors) (13).…”

Section: Discussionmentioning

confidence: 99%

Ondansetron Treatment in a Child Presenting with Chronic Intractable Pruritus

Frigon

Desparmet

2006

Pain Research and Management

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The case of a seven-year-old boy with chronic pruritus secondary to a giant congenital melanocytic nevus is presented. The pruritus did not respond to conventional antipruritic drug treatment, but responded to ondansetron, a selective antagonist of 5-hydroxytryptamine type 3 receptors.Key Words: Children; Giant congenital melanocytic nevus; Ondansetron; Pruritus; Serotonin antagonist Un traitement à l'ondansétron pour un enfant atteint d'un prurit chronique réfractaire Est présenté le cas d'un garçon de sept ans atteint d'un prurit chronique secondaire à un naevus mélanocytique géant congénital. Le prurit n'a pas répondu à un traitement classique aux antipruritiques, mais a répondu à l'ondansétron, un antagoniste sélectif des récepteurs 5-hydroxytryptamine de type 3. O ndansetron is effective against chemotherapy-induced and postoperative nausea and vomiting (1,2). Over the past few years, several publications reported on the efficacy of ondansetron in treating neuraxial opioid-induced pruritus (3-5) and uremic pruritus in continuous ambulatory peritoneal dialysis (6). The current report presents a case of a child suffering from chronic pruritus refractory to conventional antipruritic drugs who was successfully treated with ondansetron. CASE PRESENTATIONA seven-year-old African-American boy weighing 21 kg was referred to the Chronic Pain Clinic at The Montreal Children's Hospital (Montreal, Quebec) with a history of disabling pruritus that was not responding to conventional treatment. The boy was born with a giant congenital melanocytic nevus with a bathing trunk distribution. The nevus was thick and was distributed from the mid-back to the buttocks with extension to the scrotum. The child had previously undergone several partial excisions of the nevus with skin grafts. Biopsies were regularly performed to evaluate the potential for malignancy. Multiple satellite nevi, that increased in number each year, covered his whole body including his face and scalp. In addition, he had three melanin-containing lesions in the brain. The brain lesions were stable and did not increase with time. The child also suffered from chronic constipation secondary to his bathing trunk nevus for which he was treated with lactulose, a colon lavage preparation (GoLYTELY, Braintree Laboratories Inc, Canada) and a high fibre diet.The patient had suffered from generalized pruritus and scratching since his first year of life. Different antipruritic treatments were tried over the years but with poor success. He was initially treated with antihistamines -hydroxyzine and diphenhydramine. Methotrimeprazine (Nozinan, sanofi aventis Canada Inc), a neuroleptic, was added to diphenhydramine for one year. Doxepin (Sinequan, ERFA Canada Inc), an antidepressant with antihistaminic properties, and ketotifen (Zaditen, PendoPharm, Canada), a noncompetitive inhibitor of histamine type 1 (H 1 ) receptors, also failed in relieving the pruritus. The pruritus did not improve with the application of local moisturizers and a topical antipruritic (Sarna P lotion,...

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Understanding Pruritus in Systemic Disease

Cited by 134 publications

References 135 publications

Role of Pregabalin in Management of Pruritus: A Literature Review

Role of Pregabalin in Management of Pruritus: A Literature Review

Invisible mycosis fungoides—Not to be missed in chronic pruritus

Ondansetron Treatment in a Child Presenting with Chronic Intractable Pruritus

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