Anal pruritus is a common anorectal symptom that can significantly impair a patient’s quality of life,including their mental health.It can be one of the most difficult proctological conditions to treat.Patients often...Anal pruritus is a common anorectal symptom that can significantly impair a patient’s quality of life,including their mental health.It can be one of the most difficult proctological conditions to treat.Patients often delay seeking medical attention,since it is an embarrassing but non-life-threatening situation.Pruritus ani can be associated with idiopathic and secondary causes,such as anorectal diseases,cancer(anal or colorectal),dermatological and sexually transmitted diseases,fungal infections and systemic diseases.If patients are referred for a colonoscopy,this can sometimes provide the first opportunity to evaluate the perianal area.Classifications of anal pruritus are based on the abnormalities of the perianal skin,one of the most commonly used being the Washington classi-fication.A proper digital anorectal examination is important,as well as an anoscopy to help to exclude anorectal diseases or suspicious masses.Endoscopists should be aware of the common etiologies,and classification of the perianal area abnormalities should be provided in the colonoscopy report.Information on treatment possibilities and follow-up can also be provided.The treatment normally consists of a triple approach:proper hygiene,elimination of irritants,and skin care and protection.Several topical therapies have been described as possible treatments,including steroids,capsaicin,tacrolimus and methylene blue intradermal injections.展开更多
Introduction: The aim was to identify the etiologies of generalised pruritus sine materia and to determine the associated factors in Parakou. Methods: This was a retrospective observational study conducted from Januar...Introduction: The aim was to identify the etiologies of generalised pruritus sine materia and to determine the associated factors in Parakou. Methods: This was a retrospective observational study conducted from January 2011 to June 2022. The patients included were of all ages and both sexes in whom the sine materia nature of the pruritus was noted after clinical examination. These patients had an etiological assessment available or not, complete or partial. For each patient, socio-demographic, socio-cultural, socio-economic and clinical data were collected using a pre-established survey form. They were then processed and analysed using Epi Data 3.1 and SPSS version 21 software respectively. Results: The incidence of generalised pruritus sine materia was 0.89% (73 cases/8214 consultants). The predominant etiologies were aquagenic pruritus (16.4%) and intestinal parasitosis (12.3%). After a bi-variate analysis, two risk factors were identified: frequency of towel change greater than 1 month (OR = 3.02;CI<sub>95%</sub> = 0.98 - 9.31;P = 0.0486) and use of cold water for bath (OR = 3.28;CI<sub>95%</sub> = 1.09 - 9.81;P = 0.0274). Conclusion: The etiologies and associated factors of generalised pruritus sine materia found in Parakou are varied but are linked to lifestyle. There is an urgent need to raise public awareness of the need to improve lifestyle in order to reduce the frequency of pruritus sine materia. .展开更多
Objective:To explore the therapeutic effect of integrated traditional Chinese and western medicine on anal pruritus after anorectal surgery.Methods:Ninety-eight patients with anal pruritus after anorectal surgery in o...Objective:To explore the therapeutic effect of integrated traditional Chinese and western medicine on anal pruritus after anorectal surgery.Methods:Ninety-eight patients with anal pruritus after anorectal surgery in our hospital were selected as the research subjects.They were divided into two groups,the control group(50 cases)and the study group(48 cases),according to the treatment plan.The control group was under a simple western medicine treatment plan,while the study group was under an integrated traditional Chinese and western medicine treatment plan.The overall efficacy,severity of anal pruritus,time to eliminate clinical symptoms,and anxiety and depression scores of the two groups of patients under different treatment plans were compared.Results:After two weeks of treatment,the total effective rate of the study group was 95.83%,which was significantly higher than that of the control group(82.00%,P<0.05).After 7 and 14 days of treatment,the anal pruritus scores improved significantly in both the groups,but the study group was superior to the control group,with statistical difference(P<0.01).The time of disappearance of skin itching and skin damage in the study group was shorter than that in the control group.After 14 days of treatment,the anxiety and depression scores of both groups were lower than those after 7 days of treatment;however,there was statistical difference between the two groups(P<0.01).Conclusion:In the clinical treatment of anorectal postoperative diseases,such as anal pruritus,the combination of traditional Chinese and western medicine can significantly improve the symptoms of pruritus,shorten the time of disappearance of clinical symptoms,improve depression and anxiety,and create a positive clinical application value in promoting the rehabilitation of patients and improving their quality of life.展开更多
AIM To assess the role of narrow band ultraviolet B(UVB) as a treatment option in peritoneal dialysis patients with refractory uremic pruritus.METHODS In this retrospective study, 29 adult patients with end stage rena...AIM To assess the role of narrow band ultraviolet B(UVB) as a treatment option in peritoneal dialysis patients with refractory uremic pruritus.METHODS In this retrospective study, 29 adult patients with end stage renal failure on peritoneal dialysis, and who had refractory uremic pruritus, were given narrow band UVB radiation as an add-on therapy to standard care for a duration of 12 wk. The response to the pruritus was assessed both weekly and at the end of the study period using a visual analogue score(VAS).RESULTS The average VAS score at the end of the study was 3.14 ± 1.59, which was significant compared to the baseline value of 7.75 ± 1.02(P < 0.05). Improvements in symptoms were noted in 19 out of 21(90.4%) patients. However, relapse occurred in six out of the 19 patients who responded. The dropout rate was high during the study period(33.3%).CONCLUSION Narrow band UVB is effective as an add-on therapy in peritoneal dialysis patients with refractory uremic pruritus. However, the present regime is cumbersome and patient compliance is poor.展开更多
AIM:To investigate the occurrence and severity of pruritus in chronic hepatitis C patients treated with or without interferon(IFN)therapy.METHODS:A total of 89 patients with chronic hepatitis C and 55 control(non-hepa...AIM:To investigate the occurrence and severity of pruritus in chronic hepatitis C patients treated with or without interferon(IFN)therapy.METHODS:A total of 89 patients with chronic hepatitis C and 55 control(non-hepatitis)patients were asked to rate their experience of diurnal and nocturnal pruritus in the preceding week using a visual analogue scale(VAS)and a five-point scale,respectively.Blood samples were taken and serum thymus and activationregulated chemokine(TARC)levels were measured by enzyme-linked immunosorbent assay.RESULTS:A significantly greater proportion of chronic hepatitis C patients experienced nocturnal pruritus compared with control(58.4%vs 5.5%,P<0.0001).Chronic hepatitis C patients also had more severe pruritus compared with control patients,indicated by the higher mean VAS scores in both the IFN-treated and non-IFN-treated groups.In particular,patients who received combined peginterferon alfa-2b and ribavirin had significantly higher mean VAS scores than those receiving peginterferon alfa-2a or no IFN treatment.SerumTARC levels did not correlate with pruritus scores,and no significant differences in TARC levels were observed between the IFN-treated and non-IFN-treated groups.CONCLUSION:Patients with chronic hepatitis C experience pruritus more than those without.Serum TARC levels do not correlate with pruritus severity in chronic hepatitis C patients.展开更多
Obstetric cholestasis (also referred to as intrahepatic cholestasis of pregnancy—ICP) is a pruritic form of reversible cholestasis that is associated with significant fetal risks. There is a paucity of research regar...Obstetric cholestasis (also referred to as intrahepatic cholestasis of pregnancy—ICP) is a pruritic form of reversible cholestasis that is associated with significant fetal risks. There is a paucity of research regarding pregnancy outcomes of the mothers with obstetric cholestasis in the South Asian setting. Hence, the objective of this study was to determine the prevalence of obstetric cholestasis among mothers presenting with pruritus during pregnancy and to describe the characteristics and outcomes for those diagnosed with ICP in comparison with those with pruritus in the absence of ICP. Methods: All mothers presenting with pruritus to De Soyza Maternity hospital in Colombo Sri Lanka, between 1st January 2011 to 1st January 2014, were recruited for the study. A standard set of biochemical tests were used for diagnosis of ICP. An interviewer administered questionnaire and patient records were used for data collection. Presentation, characteristics and pregnancy outcomes were assessed and compared for mothers with ICP against those with pruritus in the absence of ICP. Results: The prevalence of ICP in the study population was found to be 27% (n = 27). Generalized pruritus with pruritus of the palms and soles was identified as the commonest pattern of pruritus for diagnosed with ICP. Delivery before 37 weeks (p = 0.001), meconium stained liquor (p = 0.004), placental abruption (p = 0.005), postpartum hemorrhage (p = 0.005), bleeding manifestation (p = 0.006), preterm labor (p = 0.031) and fetal distress (p = 0.035) were found to be significantly associated with the presence of ICP. Conclusions: Nearly 1/3 of mothers presenting with pruritus in pregnancy in Sri Lanka are affected by ICP which is associated with an increase in a wide range of adverse maternal and fetal outcomes compared to those with pruritus in the absence of ICP.展开更多
Summary:Mechanisms of pruritus are implicated in the dysregulation of the metabolites in the spinal cord.We investigated pruritus behavioral testing in three groups of young adult male C57B1/6 mice,including one group...Summary:Mechanisms of pruritus are implicated in the dysregulation of the metabolites in the spinal cord.We investigated pruritus behavioral testing in three groups of young adult male C57B1/6 mice,including one group treated with normal saline,while the other groups intradermally injected with a-Me-5-HT(histamine-independent pruritogen),compound 48/80(histaminedependent pruritogen)at the nape skin of the neck,respectively.Proton nuclear magnetic resonance spectroscopy(MRS)was used to compare spinal metabolites from the vertebral cervical among three groups,and to study the association of spinal metabolite ratio and pruritus intensity.The MRS-measured N-acetylaspartate-to-myoinositol ratio(NAA/Ins)was significantly correlated with the number of scratches between normal saline group and 48/80 group or a-Me-5-HT group(both P<0.0001),indicating that NAA/Ins may be a robust surrogate marker of histamine-independent/dependent pruritogen.There was significant difference in Glu/Ins between normal saline group and 48/80 group(P=0.017),indicating that Glu/Ins may be a surrogate marker of histamine-dependent pruritogen,while GABA/Ins was highly significantly different between normal saline group and a-Me-5-HT group(P=0.008),suggesting that GABA/Ins may be a surrogate marker of histamineindependent pruritogen.MRS may reflect the extent of pruritus intensity elicited by a-Me-5-HT and compound 48/80 with sensitivity similar to the number of scratches,and above potential markers need to be further validated in pre-clinical and clinical treatment trials.展开更多
Dear Sir, I am Dr. Jin Jiang, from the Department of Ophthalmology, Zhejiang Provincial People’s Hospital, Hangzhou, China. I write to present a peculiar case report of Phthiriasis palpebrarum initially misdiagnosed ...Dear Sir, I am Dr. Jin Jiang, from the Department of Ophthalmology, Zhejiang Provincial People’s Hospital, Hangzhou, China. I write to present a peculiar case report of Phthiriasis palpebrarum initially misdiagnosed as common blepharitis. Phthirus pubis (crab louse) infests mainly the hair of the pubic and inguinal regions,展开更多
Objectives: The morbidity of dry and itchy skin was high during a person’s lifetime and it had a significant negative impact. This study aimed to investigate the positive effect of silk fibroin moisturizing cream on ...Objectives: The morbidity of dry and itchy skin was high during a person’s lifetime and it had a significant negative impact. This study aimed to investigate the positive effect of silk fibroin moisturizing cream on dry skin pruritus induced by acetone/ether-water (AEW) method in mice. Method: We established a dry skin model in mice with AEW treatment, and the control group was treated with ultrapure water. The mice in AEW model group were locally administrated with silk fibroin moisturizing cream (SilkArmor)®. The transepidermal water loss (TEWL), scratching behavior, condition of skin erythema, skin histology (by hematoxylin-eosin staining) and the results of electron microscopy were measured to evaluate the positive effect of SilkArmor on dry and itchy skin in mice. Results: The TEWL value, spontaneous scratching behavior and erythema score were significantly increased after AEW modeling compared with the control group. There was no significant difference in the TEWL value, scratching behavior and erythema score between the SilkArmor group and the control group (P > 0.05). Compared with the AEW group, the value of TEWL, scratching behavior and the erythema score of mice in the AEW + SilkArmor group were improved, with statistically significant differences (P < 0.05). Skin histopathology and electron microscopy also showed that SilkArmor had certain improvement and repairment on AEW-induced skin pathological changes. Conclusions: A dry skin model was successfully established in this experiment, showing that SilkArmor brought an obvious alleviation to AEW-induced dry and itchy skin in mice.展开更多
Objective:To discuss the specific application of Zhuang Medicine Crystal Sugar Ye'An Decoction in senile skin pruritus and its effects on serum IgE detection level.Methods:90 patients with senile skin pruritus adm...Objective:To discuss the specific application of Zhuang Medicine Crystal Sugar Ye'An Decoction in senile skin pruritus and its effects on serum IgE detection level.Methods:90 patients with senile skin pruritus admitted to our hospital from February 2019 to April 2020 were randomly grouped.The general treatment effect,itching,secondary skin lesion severity,sernum IL-6,IgE level and adverse reactions between 45 patients treated with Chlorcyclizine Hydrochloride Tablets(The control group)and 45 patients treated with Crystal Sugar Ye'An Decoction were compared.Results:The total effective rate of the treatment in the observation group was 93.33%,much higher than that in the control group,75.56%.The difference was verified and statistically significant(P<0.05).Before the treatment,the itching area,frequency,duration and severity of secondary skin lesions were at the same level(P>0.05).After the treatment,the above data were all reduced,and the reduction of the observation group was more significant than that of the control group,indicating the difference was statistically significant(P<0.05).Before the treatment,there was no difference in serum IL-6 and IgE test data between the two groups(P>0.05).After the treatment,the tendency all declined,and that of the observation group was more obvious,indicating the difference was statistically significant(P<0.05).During the experiment,no obvious adverse reactions were observed in both groups.Conclusion:In the treatment of patients with senile pruritus,the application of Zhuang Medicine Crystal Sugar Ye’An Decoction is not only safe and reliable,but can promote the improvement of patients'symptoms,adjust the level of inflammatory factors,and enhance clinical efficacy.展开更多
Background:Patie nts un dergo ing hemodialysis experie nces some symptoms.Pruritus,an xiety,and sleep quality are three of the most com mon symptoms.Eve n though some pharmacological treatme nts use to cope with these...Background:Patie nts un dergo ing hemodialysis experie nces some symptoms.Pruritus,an xiety,and sleep quality are three of the most com mon symptoms.Eve n though some pharmacological treatme nts use to cope with these symptoms,they are still experie need by the patie nts at a high level.Aim:This study aimed to determine the effect of lavender oil aromatherapy on pruritus,anxiety,and sleep quality of patients undergoing hemodialysis.Method:This randomized con trolled study was carried out betwee n December 2019 and March 2020.Eighty of 895 eligible patients were included in the study.Aromatherapy inhalation and massage together applied to the patients for six weeks.5D-Itch Scale,State Anxiety Inventory(SAI),and Richard Campbell Sleep Questio nn aire(RCSQ)were used for data collecti on.IBM SPSS 25.0 were used for statistical an alysis.Mann-Whit ney U,Wilcox on sig ned-ra nks test,and repeated measures-ANOVA tests were used to compare the difference between the groups and simple regression analysis to investigate the relationship between the dependent and independent variables.Results:Most of the patients were male(57.5%)and aged between 41 and 55 years(52.5%).There was significant difference in the mean scores of SAI(Pretest:44.02±5.33,Post-test:35.40±4.52,P=0.003),5D-Itch scale(Pretest:9.80±2.04,Post-test:7.00±2.31,P=0.001),and RCSQ(Pretest:17.11±40.30,Post-test:58.55±33.74,P=0.002)with in time in the in terve ntio n group.There was a statistically significant differenee between the groups regarding the mean scores of SAI(Intervention:35.40±4.52,Control:46.84±4.62,P=0.003),5D-Itch scale(Intervention:7.00±2.31,Control:8.96±2.05,P=0.004),and RCSQ(Intervention:58.55±33.74,Control:19.93±28.36,P=0.001)after the intervention.Conclusion:After six-weeks intervention,lavender aromatherapy was found an effective way to reduce pruritus,anxiety and to improve the sleep quality of patients undergoing hemodialysis.展开更多
Objective:Inflammatory skin diseases were proved to be associated with dry skin-induced pruritus.However,the relationship between skin inflammation,skin barrier function,and pruritus remains unclarified.The present st...Objective:Inflammatory skin diseases were proved to be associated with dry skin-induced pruritus.However,the relationship between skin inflammation,skin barrier function,and pruritus remains unclarified.The present study aimed to explore this relationship using an acetone-ether-water(AEW)mouse model,and to investigate the anti-itch effects of the combined application ofβ-glucan and panthenol in a moisturizing spray in this mouse model.Methods:A dry skin-induced chronic pruritus mouse model was established by repeated AEW treatment of the skin.The pruritic behavior,skin barrier function,and expression of molecules related to pruritus and inflammation in topical lesions were measured.The effects of a spray containingβ-glucan and panthenol were observed.Thet test and one-way analysis of variance were used to evaluate differences between groups.Results:AEW treatment triggered spontaneous scratching with significantly increased numbers of scratching bouts,and disrupted the skin barrier with a significant increase in transepidermal water loss values and a significant decrease in filaggrin gene(FLG)expression(allP<0.01).AEW treatment also significantly increased the expression of NOD-like receptor family pyrin domain containing 3,apoptosis-associated speck-like protein containing a CARD,caspase-1,interleukin-1β,and tumor necrosis factor-α,as well as the pruritus-associated molecules nerve growth factor,cathepsin S,and thymic stromal lymphopoietin in the skin(allP<0.01).Application of the spray containingβ-glucan and panthenol significantly alleviated these responses,resulting in a reduced number of scratching bouts in 1 hour,reduced transepidermal water loss values,increased filaggrin mRNA expression,and reduced mRNA levels of NOD-like receptor family pyrin domain containing 3,apoptosis-associated speck-like protein containing a CARD,caspase-1,interleukin-1β,tumor necrosis factor-α,cathepsin S,thymic stromal lymphopoietin,and nerve growth factor in skin lesions(allP<0.05).Conclusion:The present results suggest a relationship between damaged skin barrier function,pruritus,and inflammation.Addingβ-glucan and panthenol to moisturizing skincare products may alleviate pruritus induced by dry skin,improve the damaged skin barrier function,and reduce the inflammatory state in local skin areas.展开更多
Background and Aims:A visual analogue score (VAS),based on application of a visual analogue scale,has been widely used to assess pruritus in clinical studies of patients with cholestatic liver disease.A VAS is a numer...Background and Aims:A visual analogue score (VAS),based on application of a visual analogue scale,has been widely used to assess pruritus in clinical studies of patients with cholestatic liver disease.A VAS is a numerical score of the severity of the perception of pruritus,and,hence,is inherently subjective.The objective of this study was to assessthe reliability of a VAS as an index of pruritus in cholestatic patients.Methods:In 8 patients with chronic pruritus due to primary biliary cholangitis,values for a VAS of pruritus were compared with corresponding measurements of scratching activity,which were generated by a monitoring system specifically designed to quantitate this activity.The relationship between individual values for the VAS and corresponding values for scratching activity during a specific interval immediately preceding the recording of the VAS was examined by determining the Spearman's rank correlation coefficient.Results:The mean Spearman's rank correlation coefficient between individual values for the VAS and corresponding mean values for scratching activity was 0.072;the range of these coefficients was-0.04 to 0.26.A VAS of pruritus is an unreliable index of scratching activity,and,hence,of the pathophysiological process responsible for the pruritus of cholestasis.Conclusion:It is concluded that the use of a VAS as a primary quantitative endpoint in trials of the efficacy of potential therapies for the pruritus of cholestasis may be inappropriate.展开更多
Genetic gain-of-function mutations of warm temperature-sensitive transient receptor potential vanilloid 3(TRPV3)channel cause Olmsted syndrome characterized by severe itching and keratoderma,indicating that pharmacolo...Genetic gain-of-function mutations of warm temperature-sensitive transient receptor potential vanilloid 3(TRPV3)channel cause Olmsted syndrome characterized by severe itching and keratoderma,indicating that pharmacological inhibition of TRPV3 may hold promise for therapy of chronic pruritus and skin diseases.However,currently available TRPV3 tool inhibitors are either nonselective or less potent,thus impeding the validation of TRPV3 as therapeutic target.Using whole-cell patch-clamp and single-channel recordings,we report the identification of two natural dicaffeoylquinic acid isomers isochlorogenic acid A(IAA)and isochlorogenic acid B(IAB)that selectively inhibit TRPV3 currents with IC50 values of 2.7±1.3 and 0.9±0.3μmol/L,respectively,and reduce the channel open probability to 3.7±1.2%and 3.2±1.1%from 26.9±5.5%,respectively.In vivo evaluation confirms that both IAA and IAB significantly reverse the ear swelling of dermatitis and chronic pruritus.Furthermore,the isomer IAB is able to rescue the keratinocyte death induced by TRPV3 agonist carvacrol.Molecular docking combined with site-directed mutations reveals two residues T636 and F666 critical for the binding of the two isomers.Taken together,our identification of isochlorogenic acids A and B that act as specific TRPV3 channel inhibitors and gating modifiers not only provides an essential pharmacological tool for further investigation of the channel pharmacology and pathology,but also holds developmental potential for treatment of dermatitis and chronic pruritus.展开更多
Background:Poor sleep quality is associated with a decrease in quality of life in patients with major burn scars,combined with pruritus and pain.Few interventions have been reported to improve the sleep quality of pat...Background:Poor sleep quality is associated with a decrease in quality of life in patients with major burn scars,combined with pruritus and pain.Few interventions have been reported to improve the sleep quality of patients with scars.In the current prospective cohort study,we investigated the efficacy of CO_(2)-ablative fractional laser(AFL)surgery vs conventional surgery in post-burn patients with hypertrophic scars with sleep quality as the primary study outcome.Methods:In total 68 consecutive patients undergoing scar surgical treatment were recruited,including a CO_(2)-AFL surgery cohort(n=35)and a conventional surgery cohort(n=33).A subgroup from the AFL cohort was selected.Sleep quality,pain and pruritus were evaluated.Multiple linear regression analyses were performed to reveal the effect of CO_(2)-AFL surgery.Results:The CO_(2)-AFL surgery cohort had significantly lower Pittsburgh sleep quality index(PSQI)global scores than the conventional surgery cohort after the last surgical treatment.In the subgroup of patients receiving hardware sleep monitoring,CO_(2)-AFL markedly increased deep sleep time,deep sleep efficiency and reduced initial sleep latency.Compared to the conventional surgery cohort,the CO_(2)-AFL cohort presented significantly lower pain and pruritus scores.Correlation analysis showed pain and pruritus were significantly associated with PSQI scores,and there were also significant correlations between pain and pruritus scores.Multiple linear regression analysis showed that surgery method was negatively linearly correlated with visual analog scale(VAS)pain score,brief pain inventory(BPI)total,VAS pruritus score,5-D itch scale total,four-item itch questionnaire(FIIQ)total and PSQI total.Conclusions:CO_(2)-AFL surgery significantly improved sleep quality and reduced pain and pruritus of hypertrophic scar patients.The alleviation of sleep disorder was associated with improvement of deep sleep quality including deep sleep time and deep sleep deficiency.Trial registration:The Chinese Clinical Trial Registry(ChiCTR200035268)approved retrospectively registration on 5 Aug 2020.展开更多
Chronic pruritus is a very common clinical symptom that seriously affects people’s quality of life.Pruritus is associated not only with skin diseases but also with a variety of systemic diseases.It brings great chall...Chronic pruritus is a very common clinical symptom that seriously affects people’s quality of life.Pruritus is associated not only with skin diseases but also with a variety of systemic diseases.It brings great challenges to clinical management.To standardize the management of chronic pruritus,experts of the Allergic Disease Committee of Chinese Dermatologist Association discussed many times and finally formed this guideline to provide reference and guidance for the clinical work of dermatologists and other physicians at all levels.展开更多
BACKGROUND Prurigo nodularis(PN)is a chronic condition characterized by a papulonodular pruriginous eruption of unknown aetiology.Currently,there are no medications for PN that the United States Food and Drug Administ...BACKGROUND Prurigo nodularis(PN)is a chronic condition characterized by a papulonodular pruriginous eruption of unknown aetiology.Currently,there are no medications for PN that the United States Food and Drug Administration has approved,which leads to very variable practices in the prescription of off-label treatments.Treatment of PN is based on clinical experience rather than controlled trials.We present our case of generalized PN,in which we had a dramatic response with dupilumab.CASE SUMMARY A 58-year-old female patient was admitted to our clinic with severe itchy,erythematous nodular lesions that were widespread all over her body,especially on the legs and back.It was learned that the patient's complaints started 4 years ago,and there was a significant increase in the lesions in the last period.Dermatological examination revealed diffuse firm erythematous excoriated nodular lesions all over the body.In the blood tests of the patient,serum Immunoglobulin E(IgE)was measured at 9330 IU/mL.The patient was diagnosed with generalized prurigo nodularis together with clinical and histopathological findings.Due to severe clinical findings and the presence of comorbidities,dupilumab treatment was planned for the patient.In the follow-up 4 mo later,it was observed that all nodular lesions healed with postinflammatory hypopigmentation.The IgE value decreased to 1500 IU/mL after 4 mo of dupilumab treatment.CONCLUSION Dupilumab treatment stands out as an effective and safe systemic treatment agent among existing systemic treatments.展开更多
Sophorae Flavescentis Radix(SFR)is a medicinal herb with many functions that are involved in anti-inflammation,antinociception,and anticancer.SFR is also used to treat a variety of itching diseases.Matrine(MT)is one o...Sophorae Flavescentis Radix(SFR)is a medicinal herb with many functions that are involved in anti-inflammation,antinociception,and anticancer.SFR is also used to treat a variety of itching diseases.Matrine(MT)is one of the main constituents in SFR and also has the effect of relieving itching,but the antipruritic mechanism is still unclear.Here,we investigated the effect of MT on antipruritus.In acute and chronic itch models,MT significantly inhibited the scratching behavior not only in acute itching induced by histamine(His),chloroquine(CQ)and compound 48/80 with a dose-depended manner,but also in the chronic pruritus models of Atopic dermatitis(AD)and Acetone-ether-water(AEW)in mice.Furthermore,MT can be detected in the blood after intraperitoneal injection(i.p.)and subcutaneous injection(s.c.).Finally,electrophysiological and calcium image results show that MT inhibits the excitatory synaptic transmission from dorsal root ganglion(DRG)to the dorsal horn of the spinal cord by suppressing presynaptic N-type calcium channels.Taken together,we believe that MT is a novel drug candidate in treating pruritus diseases,especially for histamine-independent and chronic pruritus,which might be attributed to inhibition of presynaptic N-type calcium channels.展开更多
Despite its clinical importance, the underlying central mechanisms of pruritic behaviors are poorly understood. To investigate the role of nociceptive arcuate nucleus neurons in chloro-quine-induced pruritic behaviors...Despite its clinical importance, the underlying central mechanisms of pruritic behaviors are poorly understood. To investigate the role of nociceptive arcuate nucleus neurons in chloro-quine-induced pruritic behaviors in mice, we tested the effect of arcuate nucleus neurons and interscapular brown adipose tissue (IBAT) on itch produced by intradermal injection of chloroquine in the nape of the neck. Our results provide several lines of evidence for an important role of nociceptive arcuate nucleus neurons in chloroquine-induced pruritic behavior: (1) Intradermal microinjection of chloro-quine resulted in a dramatic increase in itch behaviors accompanied by the activation of c-Fos positive neurons in arcuate nucleus; (2) Microinjection of chloroquine significantly increased IBAT temperature in the mice. These findings suggested that chloroquine-induced pruritic behaviors were associated with the activity of nociceptive arcuate nucleus neurons.展开更多
Objectives: Scabies has a different epidemiological distribution among different communities worldwide due to different social factors, management approaches and healthcare policies. The present study came to address ...Objectives: Scabies has a different epidemiological distribution among different communities worldwide due to different social factors, management approaches and healthcare policies. The present study came to address outbreaks of scabies according to the social factors in west of Iran. Methods: In a cross-sectional study, using the census sampling method, all consecutive patients with the primary diagnosis of scabies based on clinical manifestations referred to healthcare center throughout the two great provinces of Hamadan and Kermanshah at western Iran between March 2006 and February 2010 were enrolled into the study. The baseline characteristics were collected from recorded files at the healthcare centers or by interviewing with the affected patients. Results: Among 3,625,966 subjects covered by the two studied provinces, 177 cases of scabies (170 cases in Kermanshah and 7 cases in Hamadan) were identified by medical staff at the healthcare centers according to clinical manifestations (85.3%) and laboratory microscopic assessments (14.7%). The highest and the lowest prevalence rates were specified to 2009 (58.2%) and 2008 (1.7%). Regarding gender distribution of disease, 53.1% of men and 46.9% of women suffered from scabies with no significant discrepancy. In respect to age distribution of disease, the highest rates of scabies were revealed in the ages ranged 17 to 30 years (31.6%), followed by younger than 17 years (30.5%). The prevalence of scabies was dependently associated with residency in rural areas, family history of scabies, lower educational level, household density, lower monthly income, low personal hygiene, the existence of livestock or rodents at home, seasonal conditions, and movement to contaminated areas. Conclusion: West region of Iran especially Kermanshah province faced with high prevalence and this high disease burden can be determined by some potential factors such as residency in rural areas, family history of scabies, lower educational level, household density, lower monthly income, low personal hygiene, the existence of livestock or rodents at home, seasonal conditions, and movement to contaminated areas.展开更多
文摘Anal pruritus is a common anorectal symptom that can significantly impair a patient’s quality of life,including their mental health.It can be one of the most difficult proctological conditions to treat.Patients often delay seeking medical attention,since it is an embarrassing but non-life-threatening situation.Pruritus ani can be associated with idiopathic and secondary causes,such as anorectal diseases,cancer(anal or colorectal),dermatological and sexually transmitted diseases,fungal infections and systemic diseases.If patients are referred for a colonoscopy,this can sometimes provide the first opportunity to evaluate the perianal area.Classifications of anal pruritus are based on the abnormalities of the perianal skin,one of the most commonly used being the Washington classi-fication.A proper digital anorectal examination is important,as well as an anoscopy to help to exclude anorectal diseases or suspicious masses.Endoscopists should be aware of the common etiologies,and classification of the perianal area abnormalities should be provided in the colonoscopy report.Information on treatment possibilities and follow-up can also be provided.The treatment normally consists of a triple approach:proper hygiene,elimination of irritants,and skin care and protection.Several topical therapies have been described as possible treatments,including steroids,capsaicin,tacrolimus and methylene blue intradermal injections.
文摘Introduction: The aim was to identify the etiologies of generalised pruritus sine materia and to determine the associated factors in Parakou. Methods: This was a retrospective observational study conducted from January 2011 to June 2022. The patients included were of all ages and both sexes in whom the sine materia nature of the pruritus was noted after clinical examination. These patients had an etiological assessment available or not, complete or partial. For each patient, socio-demographic, socio-cultural, socio-economic and clinical data were collected using a pre-established survey form. They were then processed and analysed using Epi Data 3.1 and SPSS version 21 software respectively. Results: The incidence of generalised pruritus sine materia was 0.89% (73 cases/8214 consultants). The predominant etiologies were aquagenic pruritus (16.4%) and intestinal parasitosis (12.3%). After a bi-variate analysis, two risk factors were identified: frequency of towel change greater than 1 month (OR = 3.02;CI<sub>95%</sub> = 0.98 - 9.31;P = 0.0486) and use of cold water for bath (OR = 3.28;CI<sub>95%</sub> = 1.09 - 9.81;P = 0.0274). Conclusion: The etiologies and associated factors of generalised pruritus sine materia found in Parakou are varied but are linked to lifestyle. There is an urgent need to raise public awareness of the need to improve lifestyle in order to reduce the frequency of pruritus sine materia. .
文摘Objective:To explore the therapeutic effect of integrated traditional Chinese and western medicine on anal pruritus after anorectal surgery.Methods:Ninety-eight patients with anal pruritus after anorectal surgery in our hospital were selected as the research subjects.They were divided into two groups,the control group(50 cases)and the study group(48 cases),according to the treatment plan.The control group was under a simple western medicine treatment plan,while the study group was under an integrated traditional Chinese and western medicine treatment plan.The overall efficacy,severity of anal pruritus,time to eliminate clinical symptoms,and anxiety and depression scores of the two groups of patients under different treatment plans were compared.Results:After two weeks of treatment,the total effective rate of the study group was 95.83%,which was significantly higher than that of the control group(82.00%,P<0.05).After 7 and 14 days of treatment,the anal pruritus scores improved significantly in both the groups,but the study group was superior to the control group,with statistical difference(P<0.01).The time of disappearance of skin itching and skin damage in the study group was shorter than that in the control group.After 14 days of treatment,the anxiety and depression scores of both groups were lower than those after 7 days of treatment;however,there was statistical difference between the two groups(P<0.01).Conclusion:In the clinical treatment of anorectal postoperative diseases,such as anal pruritus,the combination of traditional Chinese and western medicine can significantly improve the symptoms of pruritus,shorten the time of disappearance of clinical symptoms,improve depression and anxiety,and create a positive clinical application value in promoting the rehabilitation of patients and improving their quality of life.
文摘AIM To assess the role of narrow band ultraviolet B(UVB) as a treatment option in peritoneal dialysis patients with refractory uremic pruritus.METHODS In this retrospective study, 29 adult patients with end stage renal failure on peritoneal dialysis, and who had refractory uremic pruritus, were given narrow band UVB radiation as an add-on therapy to standard care for a duration of 12 wk. The response to the pruritus was assessed both weekly and at the end of the study period using a visual analogue score(VAS).RESULTS The average VAS score at the end of the study was 3.14 ± 1.59, which was significant compared to the baseline value of 7.75 ± 1.02(P < 0.05). Improvements in symptoms were noted in 19 out of 21(90.4%) patients. However, relapse occurred in six out of the 19 patients who responded. The dropout rate was high during the study period(33.3%).CONCLUSION Narrow band UVB is effective as an add-on therapy in peritoneal dialysis patients with refractory uremic pruritus. However, the present regime is cumbersome and patient compliance is poor.
文摘AIM:To investigate the occurrence and severity of pruritus in chronic hepatitis C patients treated with or without interferon(IFN)therapy.METHODS:A total of 89 patients with chronic hepatitis C and 55 control(non-hepatitis)patients were asked to rate their experience of diurnal and nocturnal pruritus in the preceding week using a visual analogue scale(VAS)and a five-point scale,respectively.Blood samples were taken and serum thymus and activationregulated chemokine(TARC)levels were measured by enzyme-linked immunosorbent assay.RESULTS:A significantly greater proportion of chronic hepatitis C patients experienced nocturnal pruritus compared with control(58.4%vs 5.5%,P<0.0001).Chronic hepatitis C patients also had more severe pruritus compared with control patients,indicated by the higher mean VAS scores in both the IFN-treated and non-IFN-treated groups.In particular,patients who received combined peginterferon alfa-2b and ribavirin had significantly higher mean VAS scores than those receiving peginterferon alfa-2a or no IFN treatment.SerumTARC levels did not correlate with pruritus scores,and no significant differences in TARC levels were observed between the IFN-treated and non-IFN-treated groups.CONCLUSION:Patients with chronic hepatitis C experience pruritus more than those without.Serum TARC levels do not correlate with pruritus severity in chronic hepatitis C patients.
文摘Obstetric cholestasis (also referred to as intrahepatic cholestasis of pregnancy—ICP) is a pruritic form of reversible cholestasis that is associated with significant fetal risks. There is a paucity of research regarding pregnancy outcomes of the mothers with obstetric cholestasis in the South Asian setting. Hence, the objective of this study was to determine the prevalence of obstetric cholestasis among mothers presenting with pruritus during pregnancy and to describe the characteristics and outcomes for those diagnosed with ICP in comparison with those with pruritus in the absence of ICP. Methods: All mothers presenting with pruritus to De Soyza Maternity hospital in Colombo Sri Lanka, between 1st January 2011 to 1st January 2014, were recruited for the study. A standard set of biochemical tests were used for diagnosis of ICP. An interviewer administered questionnaire and patient records were used for data collection. Presentation, characteristics and pregnancy outcomes were assessed and compared for mothers with ICP against those with pruritus in the absence of ICP. Results: The prevalence of ICP in the study population was found to be 27% (n = 27). Generalized pruritus with pruritus of the palms and soles was identified as the commonest pattern of pruritus for diagnosed with ICP. Delivery before 37 weeks (p = 0.001), meconium stained liquor (p = 0.004), placental abruption (p = 0.005), postpartum hemorrhage (p = 0.005), bleeding manifestation (p = 0.006), preterm labor (p = 0.031) and fetal distress (p = 0.035) were found to be significantly associated with the presence of ICP. Conclusions: Nearly 1/3 of mothers presenting with pruritus in pregnancy in Sri Lanka are affected by ICP which is associated with an increase in a wide range of adverse maternal and fetal outcomes compared to those with pruritus in the absence of ICP.
基金This work was supported by grants from the National Natural Science Foundation of China(No.81670240 and No.81873467)the Medical Innovation Project in Fujian Province(No.2017-CX-48).
文摘Summary:Mechanisms of pruritus are implicated in the dysregulation of the metabolites in the spinal cord.We investigated pruritus behavioral testing in three groups of young adult male C57B1/6 mice,including one group treated with normal saline,while the other groups intradermally injected with a-Me-5-HT(histamine-independent pruritogen),compound 48/80(histaminedependent pruritogen)at the nape skin of the neck,respectively.Proton nuclear magnetic resonance spectroscopy(MRS)was used to compare spinal metabolites from the vertebral cervical among three groups,and to study the association of spinal metabolite ratio and pruritus intensity.The MRS-measured N-acetylaspartate-to-myoinositol ratio(NAA/Ins)was significantly correlated with the number of scratches between normal saline group and 48/80 group or a-Me-5-HT group(both P<0.0001),indicating that NAA/Ins may be a robust surrogate marker of histamine-independent/dependent pruritogen.There was significant difference in Glu/Ins between normal saline group and 48/80 group(P=0.017),indicating that Glu/Ins may be a surrogate marker of histamine-dependent pruritogen,while GABA/Ins was highly significantly different between normal saline group and a-Me-5-HT group(P=0.008),suggesting that GABA/Ins may be a surrogate marker of histamineindependent pruritogen.MRS may reflect the extent of pruritus intensity elicited by a-Me-5-HT and compound 48/80 with sensitivity similar to the number of scratches,and above potential markers need to be further validated in pre-clinical and clinical treatment trials.
文摘Dear Sir, I am Dr. Jin Jiang, from the Department of Ophthalmology, Zhejiang Provincial People’s Hospital, Hangzhou, China. I write to present a peculiar case report of Phthiriasis palpebrarum initially misdiagnosed as common blepharitis. Phthirus pubis (crab louse) infests mainly the hair of the pubic and inguinal regions,
文摘Objectives: The morbidity of dry and itchy skin was high during a person’s lifetime and it had a significant negative impact. This study aimed to investigate the positive effect of silk fibroin moisturizing cream on dry skin pruritus induced by acetone/ether-water (AEW) method in mice. Method: We established a dry skin model in mice with AEW treatment, and the control group was treated with ultrapure water. The mice in AEW model group were locally administrated with silk fibroin moisturizing cream (SilkArmor)®. The transepidermal water loss (TEWL), scratching behavior, condition of skin erythema, skin histology (by hematoxylin-eosin staining) and the results of electron microscopy were measured to evaluate the positive effect of SilkArmor on dry and itchy skin in mice. Results: The TEWL value, spontaneous scratching behavior and erythema score were significantly increased after AEW modeling compared with the control group. There was no significant difference in the TEWL value, scratching behavior and erythema score between the SilkArmor group and the control group (P > 0.05). Compared with the AEW group, the value of TEWL, scratching behavior and the erythema score of mice in the AEW + SilkArmor group were improved, with statistically significant differences (P < 0.05). Skin histopathology and electron microscopy also showed that SilkArmor had certain improvement and repairment on AEW-induced skin pathological changes. Conclusions: A dry skin model was successfully established in this experiment, showing that SilkArmor brought an obvious alleviation to AEW-induced dry and itchy skin in mice.
基金National Key R&D Program(N0:2017YFC1703903)Youth Fund Project of Guangxi First-Class Discipline Construction Projects(No.2019XK048)+2 种基金General Project of Guangxi First-Class Discipline Construction Projects(No.:Guijiao Scientific Research 2019XK043)Guangxi First-Class Discipline Construction Projects(No.:Gui Education Scientific Research[2018]12)The High-Level Talent Team Cultivation Project of Qihuang Engineering of the Guangxi University of Chinese Medicine(No.2018005)。
文摘Objective:To discuss the specific application of Zhuang Medicine Crystal Sugar Ye'An Decoction in senile skin pruritus and its effects on serum IgE detection level.Methods:90 patients with senile skin pruritus admitted to our hospital from February 2019 to April 2020 were randomly grouped.The general treatment effect,itching,secondary skin lesion severity,sernum IL-6,IgE level and adverse reactions between 45 patients treated with Chlorcyclizine Hydrochloride Tablets(The control group)and 45 patients treated with Crystal Sugar Ye'An Decoction were compared.Results:The total effective rate of the treatment in the observation group was 93.33%,much higher than that in the control group,75.56%.The difference was verified and statistically significant(P<0.05).Before the treatment,the itching area,frequency,duration and severity of secondary skin lesions were at the same level(P>0.05).After the treatment,the above data were all reduced,and the reduction of the observation group was more significant than that of the control group,indicating the difference was statistically significant(P<0.05).Before the treatment,there was no difference in serum IL-6 and IgE test data between the two groups(P>0.05).After the treatment,the tendency all declined,and that of the observation group was more obvious,indicating the difference was statistically significant(P<0.05).During the experiment,no obvious adverse reactions were observed in both groups.Conclusion:In the treatment of patients with senile pruritus,the application of Zhuang Medicine Crystal Sugar Ye’An Decoction is not only safe and reliable,but can promote the improvement of patients'symptoms,adjust the level of inflammatory factors,and enhance clinical efficacy.
文摘Background:Patie nts un dergo ing hemodialysis experie nces some symptoms.Pruritus,an xiety,and sleep quality are three of the most com mon symptoms.Eve n though some pharmacological treatme nts use to cope with these symptoms,they are still experie need by the patie nts at a high level.Aim:This study aimed to determine the effect of lavender oil aromatherapy on pruritus,anxiety,and sleep quality of patients undergoing hemodialysis.Method:This randomized con trolled study was carried out betwee n December 2019 and March 2020.Eighty of 895 eligible patients were included in the study.Aromatherapy inhalation and massage together applied to the patients for six weeks.5D-Itch Scale,State Anxiety Inventory(SAI),and Richard Campbell Sleep Questio nn aire(RCSQ)were used for data collecti on.IBM SPSS 25.0 were used for statistical an alysis.Mann-Whit ney U,Wilcox on sig ned-ra nks test,and repeated measures-ANOVA tests were used to compare the difference between the groups and simple regression analysis to investigate the relationship between the dependent and independent variables.Results:Most of the patients were male(57.5%)and aged between 41 and 55 years(52.5%).There was significant difference in the mean scores of SAI(Pretest:44.02±5.33,Post-test:35.40±4.52,P=0.003),5D-Itch scale(Pretest:9.80±2.04,Post-test:7.00±2.31,P=0.001),and RCSQ(Pretest:17.11±40.30,Post-test:58.55±33.74,P=0.002)with in time in the in terve ntio n group.There was a statistically significant differenee between the groups regarding the mean scores of SAI(Intervention:35.40±4.52,Control:46.84±4.62,P=0.003),5D-Itch scale(Intervention:7.00±2.31,Control:8.96±2.05,P=0.004),and RCSQ(Intervention:58.55±33.74,Control:19.93±28.36,P=0.001)after the intervention.Conclusion:After six-weeks intervention,lavender aromatherapy was found an effective way to reduce pruritus,anxiety and to improve the sleep quality of patients undergoing hemodialysis.
基金supported by the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(No.CAMS-2017-I2M-1-011)。
文摘Objective:Inflammatory skin diseases were proved to be associated with dry skin-induced pruritus.However,the relationship between skin inflammation,skin barrier function,and pruritus remains unclarified.The present study aimed to explore this relationship using an acetone-ether-water(AEW)mouse model,and to investigate the anti-itch effects of the combined application ofβ-glucan and panthenol in a moisturizing spray in this mouse model.Methods:A dry skin-induced chronic pruritus mouse model was established by repeated AEW treatment of the skin.The pruritic behavior,skin barrier function,and expression of molecules related to pruritus and inflammation in topical lesions were measured.The effects of a spray containingβ-glucan and panthenol were observed.Thet test and one-way analysis of variance were used to evaluate differences between groups.Results:AEW treatment triggered spontaneous scratching with significantly increased numbers of scratching bouts,and disrupted the skin barrier with a significant increase in transepidermal water loss values and a significant decrease in filaggrin gene(FLG)expression(allP<0.01).AEW treatment also significantly increased the expression of NOD-like receptor family pyrin domain containing 3,apoptosis-associated speck-like protein containing a CARD,caspase-1,interleukin-1β,and tumor necrosis factor-α,as well as the pruritus-associated molecules nerve growth factor,cathepsin S,and thymic stromal lymphopoietin in the skin(allP<0.01).Application of the spray containingβ-glucan and panthenol significantly alleviated these responses,resulting in a reduced number of scratching bouts in 1 hour,reduced transepidermal water loss values,increased filaggrin mRNA expression,and reduced mRNA levels of NOD-like receptor family pyrin domain containing 3,apoptosis-associated speck-like protein containing a CARD,caspase-1,interleukin-1β,tumor necrosis factor-α,cathepsin S,thymic stromal lymphopoietin,and nerve growth factor in skin lesions(allP<0.05).Conclusion:The present results suggest a relationship between damaged skin barrier function,pruritus,and inflammation.Addingβ-glucan and panthenol to moisturizing skincare products may alleviate pruritus induced by dry skin,improve the damaged skin barrier function,and reduce the inflammatory state in local skin areas.
文摘Background and Aims:A visual analogue score (VAS),based on application of a visual analogue scale,has been widely used to assess pruritus in clinical studies of patients with cholestatic liver disease.A VAS is a numerical score of the severity of the perception of pruritus,and,hence,is inherently subjective.The objective of this study was to assessthe reliability of a VAS as an index of pruritus in cholestatic patients.Methods:In 8 patients with chronic pruritus due to primary biliary cholangitis,values for a VAS of pruritus were compared with corresponding measurements of scratching activity,which were generated by a monitoring system specifically designed to quantitate this activity.The relationship between individual values for the VAS and corresponding values for scratching activity during a specific interval immediately preceding the recording of the VAS was examined by determining the Spearman's rank correlation coefficient.Results:The mean Spearman's rank correlation coefficient between individual values for the VAS and corresponding mean values for scratching activity was 0.072;the range of these coefficients was-0.04 to 0.26.A VAS of pruritus is an unreliable index of scratching activity,and,hence,of the pathophysiological process responsible for the pruritus of cholestasis.Conclusion:It is concluded that the use of a VAS as a primary quantitative endpoint in trials of the efficacy of potential therapies for the pruritus of cholestasis may be inappropriate.
基金supported by National Natural Science Foundation of China(81903734,81973299 and 81573410)the Ministry of Science and Technology of the People’s Republic of China(2018ZX09711001-004-006)。
文摘Genetic gain-of-function mutations of warm temperature-sensitive transient receptor potential vanilloid 3(TRPV3)channel cause Olmsted syndrome characterized by severe itching and keratoderma,indicating that pharmacological inhibition of TRPV3 may hold promise for therapy of chronic pruritus and skin diseases.However,currently available TRPV3 tool inhibitors are either nonselective or less potent,thus impeding the validation of TRPV3 as therapeutic target.Using whole-cell patch-clamp and single-channel recordings,we report the identification of two natural dicaffeoylquinic acid isomers isochlorogenic acid A(IAA)and isochlorogenic acid B(IAB)that selectively inhibit TRPV3 currents with IC50 values of 2.7±1.3 and 0.9±0.3μmol/L,respectively,and reduce the channel open probability to 3.7±1.2%and 3.2±1.1%from 26.9±5.5%,respectively.In vivo evaluation confirms that both IAA and IAB significantly reverse the ear swelling of dermatitis and chronic pruritus.Furthermore,the isomer IAB is able to rescue the keratinocyte death induced by TRPV3 agonist carvacrol.Molecular docking combined with site-directed mutations reveals two residues T636 and F666 critical for the binding of the two isomers.Taken together,our identification of isochlorogenic acids A and B that act as specific TRPV3 channel inhibitors and gating modifiers not only provides an essential pharmacological tool for further investigation of the channel pharmacology and pathology,but also holds developmental potential for treatment of dermatitis and chronic pruritus.
基金supported by the Special Scientific Research Fund of the Public Welfare Profession of China(201502028)the Excellent Discipline Leader Training Program of Shanghai Health System(No.2017BR037)+2 种基金the NationalNatural Science Foundation of China(No.81772091)Clinical Research Plan of Shanghai Hospital Devel-opment Center(No.SHDC2020CR3039B)Shanghai Rising-Star Program(17QB1403300).
文摘Background:Poor sleep quality is associated with a decrease in quality of life in patients with major burn scars,combined with pruritus and pain.Few interventions have been reported to improve the sleep quality of patients with scars.In the current prospective cohort study,we investigated the efficacy of CO_(2)-ablative fractional laser(AFL)surgery vs conventional surgery in post-burn patients with hypertrophic scars with sleep quality as the primary study outcome.Methods:In total 68 consecutive patients undergoing scar surgical treatment were recruited,including a CO_(2)-AFL surgery cohort(n=35)and a conventional surgery cohort(n=33).A subgroup from the AFL cohort was selected.Sleep quality,pain and pruritus were evaluated.Multiple linear regression analyses were performed to reveal the effect of CO_(2)-AFL surgery.Results:The CO_(2)-AFL surgery cohort had significantly lower Pittsburgh sleep quality index(PSQI)global scores than the conventional surgery cohort after the last surgical treatment.In the subgroup of patients receiving hardware sleep monitoring,CO_(2)-AFL markedly increased deep sleep time,deep sleep efficiency and reduced initial sleep latency.Compared to the conventional surgery cohort,the CO_(2)-AFL cohort presented significantly lower pain and pruritus scores.Correlation analysis showed pain and pruritus were significantly associated with PSQI scores,and there were also significant correlations between pain and pruritus scores.Multiple linear regression analysis showed that surgery method was negatively linearly correlated with visual analog scale(VAS)pain score,brief pain inventory(BPI)total,VAS pruritus score,5-D itch scale total,four-item itch questionnaire(FIIQ)total and PSQI total.Conclusions:CO_(2)-AFL surgery significantly improved sleep quality and reduced pain and pruritus of hypertrophic scar patients.The alleviation of sleep disorder was associated with improvement of deep sleep quality including deep sleep time and deep sleep deficiency.Trial registration:The Chinese Clinical Trial Registry(ChiCTR200035268)approved retrospectively registration on 5 Aug 2020.
文摘Chronic pruritus is a very common clinical symptom that seriously affects people’s quality of life.Pruritus is associated not only with skin diseases but also with a variety of systemic diseases.It brings great challenges to clinical management.To standardize the management of chronic pruritus,experts of the Allergic Disease Committee of Chinese Dermatologist Association discussed many times and finally formed this guideline to provide reference and guidance for the clinical work of dermatologists and other physicians at all levels.
文摘BACKGROUND Prurigo nodularis(PN)is a chronic condition characterized by a papulonodular pruriginous eruption of unknown aetiology.Currently,there are no medications for PN that the United States Food and Drug Administration has approved,which leads to very variable practices in the prescription of off-label treatments.Treatment of PN is based on clinical experience rather than controlled trials.We present our case of generalized PN,in which we had a dramatic response with dupilumab.CASE SUMMARY A 58-year-old female patient was admitted to our clinic with severe itchy,erythematous nodular lesions that were widespread all over her body,especially on the legs and back.It was learned that the patient's complaints started 4 years ago,and there was a significant increase in the lesions in the last period.Dermatological examination revealed diffuse firm erythematous excoriated nodular lesions all over the body.In the blood tests of the patient,serum Immunoglobulin E(IgE)was measured at 9330 IU/mL.The patient was diagnosed with generalized prurigo nodularis together with clinical and histopathological findings.Due to severe clinical findings and the presence of comorbidities,dupilumab treatment was planned for the patient.In the follow-up 4 mo later,it was observed that all nodular lesions healed with postinflammatory hypopigmentation.The IgE value decreased to 1500 IU/mL after 4 mo of dupilumab treatment.CONCLUSION Dupilumab treatment stands out as an effective and safe systemic treatment agent among existing systemic treatments.
文摘Sophorae Flavescentis Radix(SFR)is a medicinal herb with many functions that are involved in anti-inflammation,antinociception,and anticancer.SFR is also used to treat a variety of itching diseases.Matrine(MT)is one of the main constituents in SFR and also has the effect of relieving itching,but the antipruritic mechanism is still unclear.Here,we investigated the effect of MT on antipruritus.In acute and chronic itch models,MT significantly inhibited the scratching behavior not only in acute itching induced by histamine(His),chloroquine(CQ)and compound 48/80 with a dose-depended manner,but also in the chronic pruritus models of Atopic dermatitis(AD)and Acetone-ether-water(AEW)in mice.Furthermore,MT can be detected in the blood after intraperitoneal injection(i.p.)and subcutaneous injection(s.c.).Finally,electrophysiological and calcium image results show that MT inhibits the excitatory synaptic transmission from dorsal root ganglion(DRG)to the dorsal horn of the spinal cord by suppressing presynaptic N-type calcium channels.Taken together,we believe that MT is a novel drug candidate in treating pruritus diseases,especially for histamine-independent and chronic pruritus,which might be attributed to inhibition of presynaptic N-type calcium channels.
基金supported by grants from the National Natural Science Foundation of China (No.81071307,No.81271766)
文摘Despite its clinical importance, the underlying central mechanisms of pruritic behaviors are poorly understood. To investigate the role of nociceptive arcuate nucleus neurons in chloro-quine-induced pruritic behaviors in mice, we tested the effect of arcuate nucleus neurons and interscapular brown adipose tissue (IBAT) on itch produced by intradermal injection of chloroquine in the nape of the neck. Our results provide several lines of evidence for an important role of nociceptive arcuate nucleus neurons in chloroquine-induced pruritic behavior: (1) Intradermal microinjection of chloro-quine resulted in a dramatic increase in itch behaviors accompanied by the activation of c-Fos positive neurons in arcuate nucleus; (2) Microinjection of chloroquine significantly increased IBAT temperature in the mice. These findings suggested that chloroquine-induced pruritic behaviors were associated with the activity of nociceptive arcuate nucleus neurons.
文摘Objectives: Scabies has a different epidemiological distribution among different communities worldwide due to different social factors, management approaches and healthcare policies. The present study came to address outbreaks of scabies according to the social factors in west of Iran. Methods: In a cross-sectional study, using the census sampling method, all consecutive patients with the primary diagnosis of scabies based on clinical manifestations referred to healthcare center throughout the two great provinces of Hamadan and Kermanshah at western Iran between March 2006 and February 2010 were enrolled into the study. The baseline characteristics were collected from recorded files at the healthcare centers or by interviewing with the affected patients. Results: Among 3,625,966 subjects covered by the two studied provinces, 177 cases of scabies (170 cases in Kermanshah and 7 cases in Hamadan) were identified by medical staff at the healthcare centers according to clinical manifestations (85.3%) and laboratory microscopic assessments (14.7%). The highest and the lowest prevalence rates were specified to 2009 (58.2%) and 2008 (1.7%). Regarding gender distribution of disease, 53.1% of men and 46.9% of women suffered from scabies with no significant discrepancy. In respect to age distribution of disease, the highest rates of scabies were revealed in the ages ranged 17 to 30 years (31.6%), followed by younger than 17 years (30.5%). The prevalence of scabies was dependently associated with residency in rural areas, family history of scabies, lower educational level, household density, lower monthly income, low personal hygiene, the existence of livestock or rodents at home, seasonal conditions, and movement to contaminated areas. Conclusion: West region of Iran especially Kermanshah province faced with high prevalence and this high disease burden can be determined by some potential factors such as residency in rural areas, family history of scabies, lower educational level, household density, lower monthly income, low personal hygiene, the existence of livestock or rodents at home, seasonal conditions, and movement to contaminated areas.
