Cancer incidence among patients with a hospital diagnosis of pruritus: a nationwide Danish cohort study

Johannesdottir, Sigrun Alba; Farkas, Dóra Körmendiné; Vinding, Gabrielle Randskov; Pedersen, Lars; Lamberg, Anna Lei; Sørensen, Henrik Toft; Olesen, Anne Braae

doi:10.1111/bjd.13157

Cited by 40 publications

(20 citation statements)

References 38 publications

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“…A 13% higher than expected number of both hematological and various solid cancers among patients with itch was found. This refers especially to hematological cancers, above all Hodgkin lymphoma (32). However the study was unable to differentiate between acute and chronic itch.…”

Section: Prevalence and Incidencementioning

confidence: 94%

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Paraneoplastic Itch: An Expert Position Statement from the Special Interest Group (SIG) of the International Forum on the Study of Itch (IFSI)

Weißhaar¹,

Weiß²,

Mettang³

et al. 2015

Acta Derm Venerol

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In clinical practice, the term "paraneoplastic itch" is used to describe itch in patients with cancer. Patients with hematological or solid tumor malignancies can be affected. In general, paraneoplastic itch is considered a rare disorder. However, paraneoplastic itch in hematological malignancies such as polycythemia vera and lymphoma are relatively frequent while other forms of paraneoplastic itch are in fact extremely rare. The true frequency of this symptom is unclear, epidemiological data in this field are limited. Itch in malignant disease may additionally impair patients' quality of life. A population-based cohort study showed that chronic itch without concomitant skin changes is a risk factor for having undiagnosed hematologic and bile duct malignancies. Paraneoplastic itch is rather resistant to treatment. In 2012, an interdisciplinary interest group of physicians and researchers was founded, aiming to generate a clear definition of paraneoplastic itch. In this paper we briefly review the current knowledge and aim to define what can be summarized under the term "paraneoplastic itch".

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Section: Prevalence and Incidencementioning

confidence: 94%

“…According to the authors, screening for malignancy should be limited to the evaluation of these two conditions (31). A nationwide Danish cohort study based on registry data assessed the association between hospital inpatient and outpatient diagnosis of itch and cancer incidence (32). The 1-year absolute cancer risk was 1.63%.…”

Section: Prevalence and Incidencementioning

confidence: 99%

Paraneoplastic Itch: An Expert Position Statement from the Special Interest Group (SIG) of the International Forum on the Study of Itch (IFSI)

Weißhaar¹,

Weiß²,

Mettang³

et al. 2015

Acta Derm Venerol

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“…Die Analyse ergab bei diesen Patienten im Vergleich zur Allgemeinbevölkerung eine Verdoppelung des Risikos, eine maligne hämatologische Erkrankung zu entwickeln, und ein 3-fach erhöhtes Risiko für ein Malignom der Gallengänge [4]. Eine ähnliche Studie, in der 12 813 Patienten mit chronischem Juckreiz begleitet wurden, ermittelte im Vergleich zur Allgemeinbevölkerung einen Anstieg der Inzidenz von Krebserkrankungen um insgesamt 13% und von hämatologischen Krebserkrankungen um 68% über einen Zeitraum von 5 Jahren [5]. Paraneoplastischer Pruritus kommt am häufigsten bei lymphoproliferativen malignen Erkrankungen vor, unter anderem bei multiplem Myelom, Non-Hodgkin-Lymphomen (15% Prävalenz) und Hodgkin-Lymphomen (25% Prävalenz) [6,7,8].…”

Section: Definition Und Klinische Merkmaleunclassified

Management von paraneoplastischem Pruritus

Rowe¹,

Yosipovitch²

2018

Kompass Dermatol

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Paraneoplastischer Pruritus tritt als systemische Reaktion auf eine zugrunde liegende maligne Erkrankung auf. Paraneoplastischer Pruritus ist am häufigsten mit malignen lymphoproliferativen Erkrankungen sowie soliden Tumoren, die zu Cholestase führen, assoziiert. Paraneoplastischer Pruritus kann sich sowohl ohne primären Hautausschlag manifestieren als auch in Verbindung mit dermatologischen Erkrankungen wie Erythrodermie, Acanthosis nigricans, Dermatomyositis (DM), transitorischer akantholytischer Dermatose (Morbus Grover) oder eruptiver seborrhoischer Keratose. Die Behandlung des paraneoplastischen Pruritus beruht primär auf der Behandlung der zugrunde liegenden malignen Erkrankung, die ursächlich für die systemische Reaktion ist. Wenn die maligne Erkrankung nicht auf Behandlung anspricht, können andere Therapien beim paraneoplastischen Pruritus wirksam sein, wie selektive Serotonin-Wiederaufnahmehemmer, Mirtazapin, Gabapentin, Thalidomid, Opioide, Aprepitant und Histon-Deacetylase-Inhibitoren. Übersetzung aus Curr Probl Dermatol. Basel, Karger, 2016, vol 50, pp 149-154 (DOI: 10.1159/000446060)

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“…The 1-year absolute risk of a cancer diagnosis was 1.6%; therefore, 155 patients with pruritus would need to be evaluated for malignancy to detect one additional neoplasm (Johannesdottir et al, 2014). Patients were followed from 1978 to 2011 and first-time cancer diagnoses were recorded.…”

Section: Prevalence Of Itch In Malignancymentioning

confidence: 99%

Malignancy‐associated pruritus

Rowe

Yosipovitch

2015

European Journal of Pain

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Malignancy-associated pruritus can be the result of a neoplasm's local effect on tissue or due to the systemic reaction to malignancy. A systemic reaction to malignancy has been termed 'paraneoplastic itch' and can be the first sign of an underlying malignancy. Paraneoplastic itch is most commonly caused by lymphoproliferative malignancies, and severity of itch correlates with stage of disease in Hodgkin's lymphoma and polycythemia vera. Non-melanoma skin cancer is the most common type of malignancy-associated pruritus, and recent data indicate that pruritus is associated with more than one-third of non-melanoma skin cancers. Cutaneous T-cell lymphomas (CTCL), particularly more advanced stages, cause intractable pruritus and recent investigations into the pathophysiology of CTCL-associated itch have implicated cyotokine interleukin-31 as a putative mediator. Treatments that reduce itch in CTCL patients, such as histone deacetylase inhibitors (HDACi), Mogamulizumab, a novel monoclonal antibody against chemokine receptor type-4, and oral corticosteroids, have demonstrated a correlation between their anti-pruritic effect and reduced serum levels of interleukin-31.

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Cancer incidence among patients with a hospital diagnosis of pruritus: a nationwide Danish cohort study

Abstract: Pruritus may be a marker of occult cancer. Further studies are needed to assess the prognostic benefit of screening for cancer in patients with pruritus.

Cited by 40 publications

References 38 publications

Paraneoplastic Itch: An Expert Position Statement from the Special Interest Group (SIG) of the International Forum on the Study of Itch (IFSI)

Paraneoplastic Itch: An Expert Position Statement from the Special Interest Group (SIG) of the International Forum on the Study of Itch (IFSI)

Management von paraneoplastischem Pruritus

Malignancy‐associated pruritus

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