“…Keratinocytes release several itch mediators and itch enhancers, such as leukotriene B 4 Andoh et al, 2001Andoh et al, , 2004Andoh et al, , 2009, thromboxane A 2 (Andoh et al, 2007), and nitric oxide (Andoh and Kuraishi, 2003). Recently, it has been shown that leukotriene B 4 is produced in cultured keratinocytes by stimulation of PAR 2 receptors and that intradermal PAR 2 agonist-induced scratching is suppressed by a 5-lipoxygenase inhibitor in mice (Zhu et al, 2009). These findings taken together raise the possibility that serine proteases secreted by dermatophytes activate PAR 2 receptors in the epidermal keratinocytes to secrete itch mediators including leukotriene B 4 .…”