Dermatologic clinics
-
Neuropathic pruritus is a challenging condition that can be caused by injury or dysfunction in any part of the nervous system. A vast array of clinical pictures exist, including both localized and generalized pruritus, and their principal entities are described in this article. ⋯ The management of neuropathic itch is demanding and the majority of interventions are not curative. The best treatment options include anticonvulsants, topical anesthetics, and capsaicin.
-
Chronic pruritus is a common condition that has a detrimental impact on quality of life. As the molecular pathogenesis of itch is elucidated, novel therapies that disrupt itch pathways are being investigated. Emerging treatments include drugs targeting the neural system, drugs targeting the immune system, antihistamines, bile acid transport inhibitors, and topical drugs that work through a variety of mechanisms such as phosphodiesterase-4 inhibition or targeting of nerve ion channels. Many of these therapies show promising results in the treatment of chronic itch of various etiologies, such as atopic dermatitis, psoriasis, uremic pruritus, and cholestatic pruritus.
-
Chronic pruritus, or itch lasting greater than 6 weeks, is an increasingly common and debilitating medical problem. Recent studies have unveiled previously unrecognized neuroimmune axes whereby inflammatory cytokines act directly on the nervous system to promote itch. ⋯ This article reviews the pathophysiology of multiple chronic itch disorders, including atopic dermatitis, chronic idiopathic pruritus, chronic urticaria, and prurigo nodularis. Furthermore, new and emerging immunomodulatory therapies that will likely alter current treatment paradigms are discussed.