Acta dermato-venereologica
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Acta Derm. Venereol. · Jan 2008
ReviewBiopsychosocial mechanisms of chronic itch in patients with skin diseases: a review.
Itch is a major feature of many skin diseases, which adversely affects patient's quality of life. Besides disease severity, psychophysiological factors have been proposed to influence the itch sensation. In this review the evidence for a biopsychosocial model of itch is described, focusing in particular on evidence for the effects of personality characteristics, external stressors, cognitive, behavioural and social factors, and the possible mediating role of physiological processes. ⋯ Furthermore, cognitive factors, such as helplessness and worrying, and the behavioural response of scratching have been indicated as possible worsening factors. Overall, findings are in favour of a biopsychosocial model for the itch sensation. However, there is a strong need for more, methodologically sound research in order fully to understand the processes underlying the itch sensation.
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Acta Derm. Venereol. · Jan 2008
Controlled Clinical TrialOcclusive treatment enhances efficacy of tacrolimus 0.1% ointment in adult patients with vitiligo: results of a placebo-controlled 12-month prospective study.
Topical tacrolimus was recently introduced as a novel therapeutic option in vitiligo. Excellent results were seen mainly on the face and neck areas. We treated 30 adult vitiligo patients with tacrolimus 0.1% ointment twice daily, and compared the results with those of placebo ointment. ⋯ There was no significant elevation in tacrolimus blood levels, taking into account that occlusion was performed only on limited parts of the body. In conclusion, tacrolimus 0.1% ointment proved an effective and safe treatment option for adult patients with vitiligo. Beyond the face and neck areas, repigmentation could be achieved only by additional occlusion.
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Patients with acne often scratch their lesions. As scratching is also a part of the response to pruritic stimuli, this study aimed to determine whether itching accompanies acne. A total of 108 teenagers (mean age 15.8+/-1.8 years) with acne were included in the study. ⋯ Itching episodes were of short duration in most subjects (<1 min: 51.9%; up to 10 min: 38.9%) and occurred infrequently (several times a week: 24.5%; at least once a month: 30.2%; less than once a month: 37.7%). However, 31.5% of patients reported that they had used medical treatment to reduce itching due to acne lesions. We conclude that itching of mild to moderate severity is a relatively common concomitant symptom of acne lesions.