Cyclosporine in Cholinergic Itch

Abstract

Cholinergic itch is part of symptom complex that also includes cholinergic erythema and cholinergic urticaria. It mostly occurs during the winters among young adults. It is characterized by onset of severe itching or burning sensation all over body, mostly, on exposure to sunlight, warm atmosphere and in some cases after hot and spicy food intake. In most of the cases, it is poorly responsive to antihistamine therapy. Materials and methods: This was a prospective, open labeled, clinical study done in patients of cholinergic itch, refractory to both sedating and non sedating anti-histamine drugs, who attended dermatology clinic of our tertiary care center from November, 2020 to February, 2021. Oral cyclosporine was given as treatment. Numerical rating scale (NRS) was used to record the treatment response. Results: Twenty patients with cholinergic itch meeting inclusion criteria were included in the study. Mean age of disease onset was 19.5 years. Average duration of each episode was 4.4-8 minutes. More than one site was involved in all patients with trunk being the commonest (100%). There was significant reduction in the number of episodes and cholinergic itch severity (mean NRS=7.8 to 0.3 at the end of second week after initiating cyclosporine therapy). P value of the study was <0.0001. Statistics: Mean and standard deviation were used as measure of central tendency. Paired t test was applied to analyze the data obtained. Conclusion: Oral cyclosporine effectively controlled cholinergic itch in all included patients. Drug was well tolerated by the patients.