Itch: Epidemiology, clinical presentation, and diagnostic workup

Roh, Youkyung S.; Choi, Justin; Sutaria, Nishadh; Kwatra, Shawn G.

doi:10.1016/j.jaad.2021.07.076

Cited by 49 publications

(49 citation statements)

References 122 publications

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“…Itch was reported to be the single most burdensome symptom of AD in adults, 6 and a significant symptom for children as well, 7 affecting not only patients but also their caregivers 8 . Frequent scratching induces a self‐perpetuating itch‐scratch cycle that has a pronounced impact on patients' QoL, 5,9,10 including sleep disturbances resulting from chronic itch 11–15 . Additionally, the itch from AD was shown to be a cost burden to patients 16 .…”

Section: Introductionmentioning

confidence: 99%

Rapid pruritus reduction with ruxolitinib cream treatment in patients with atopic dermatitis

Blauvelt

Kircik

Papp

et al. 2022

Acad Dermatol Venereol

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Background: Ruxolitinib cream is a topical formulation of ruxolitinib, a Janus kinase (JAK) 1/JAK2 inhibitor. Objectives:To report timing and magnitude of effect of ruxolitinib cream on itch in patients with atopic dermatitis (AD), a highly pruritic inflammatory skin disease. Methods: Two phase 3 trials (TRuE-AD1 [NCT03745638]/TRuE-AD2[NCT03745651]) enrolled patients aged ≥12 years with AD for ≥2 years, Investigator's Global Assessment score of 2 or 3, and 3%-20% affected body surface area. Patients (total N = 1249; median age, 32 years) were randomised (2:2:1) to twice daily 0.75% ruxolitinib cream, 1.5% ruxolitinib cream or vehicle cream for 8 weeks of doubleblinded treatment. Worst itch was measured using the numerical rating scale (NRS).

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Section: Introductionmentioning

confidence: 99%

Rapid pruritus reduction with ruxolitinib cream treatment in patients with atopic dermatitis

Blauvelt

Kircik

Papp

et al. 2022

Acad Dermatol Venereol

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“…Pruritus (itch) is an unpleasant feeling that results in scratching (1)(2)(3)(4). Chronic pruritus is defined as an itching that lasts for >6 weeks (5), and is a common symptom of various dermatologic diseases, such as psoriasis, atopic dermatitis, and allergic contact dermatitis, and systemic diseases, such as cholestasis, and diabetes (6). Chronic itch causes serious skin damage, makes sleeping difficult, and affects patients' quality of life.…”

Section: Introductionmentioning

confidence: 99%

Melatonin attenuates acute and chronic itch in mice: the antioxidant and anti-inflammatory effects of melatonin receptors

Zhang¹,

Zhang²,

Huang³

et al. 2022

Ann Transl Med

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Background: Itch is a common symptom of skin diseases and significantly reduces patients' quality of life.Melatonin has anti-inflammatory and antioxidant effects. Our study examined the potential anti-itch effects of melatonin (N-acetyl-5-methoxytryptamine) in mice. Methods:We detected the effects of melatonin and its receptors on acute and chronic itch by conducting itching behavioral experiments in male C57 mice. Reactive oxygen species (ROS) levels and calcium ion (Ca 2+ ) mobilization during acute itching production were explored using flow cytometry and calcium imaging techniques. Melatonin expression in the serum of the chronic itch model mice was determined by enzymelinked immunoassays. Hematoxylin and eosin staining show the effects of melatonin on skin thickness in a chronic itch model. Cytokine and chemokine levels were determined by quantitative polymerase chain reaction.Results: We discovered that compound 48/80 (C48/80)-and chloroquine (CQ)-induced scratching were significantly decreased by intraperitoneal (i.p), intradermal, and intrathecal administration of melatonin in a dose-dependent manner in mice, and the co-administration of melatonin receptor antagonists abolished the anti-itch effects of i.d melatonin. The incubation of melatonin significantly decreased the intracellular ROS levels induced by C48/80 and CQ in cultured ND7/23 cells from a mouse x rat hybridoma nerve as neuron. Melatonin inhibited intracellular Ca 2+ increases induced by CQ (but not C48/80) in cultured dorsal root ganglia (DRG) neurons. Melatonin (50 mg/kg i.p) attenuated imiquimod (IMQ)-or acetone and diethyl ether followed by acetone-ether-water (AEW)-induced chronic itch and epidermal hyperplasia in mice.Finally, melatonin treatment reduced the IMQ-induced expression of ST2 and interleukin-33 (IL-33) or the AEW-induced expression of interleukin 31 (IL-31) and interleukin 31 receptor A (IL-31 RA) in the mice.Conclusions: Collectively, our results indicate that melatonin attenuates acute and chronic itch, possibly via melatonin receptors, and its antioxidant, and anti-inflammatory effects in mice.

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“…Its pathogenesis is diverse and involves a complex histaminergic and non-histaminergic pathway, where the crosstalk between the immune system, cutaneous and neuronal cells has an impact on numerous dermatological and systemic diseases. Among the known pruritogens that signal through shared Janus kinase pathways, the most important roles are played by Th2 cytokines (IL-4, IL-13, IL-31), thymic stromal lymphopoietin, periostin, substance P, neurokinin 1R, neurotrophins nerve growth factor, autotaxin, histamine H4 receptor and oncostatin M [ 42 , 43 , 44 ]. In the inflamed lesional skin of AD patients compared to healthy controls, cells of the inflammatory, including eosinophils, basophils and lymphocytes, infiltrate and have been described to release various pruritogens and through their interaction with neuronal cells, which is correlated with itch severity.…”

Section: Discussionmentioning

confidence: 99%

Serum Levels of Eosinophil-Derived Neurotoxin, Platelet-Activating Factor and Vascular Endothelial Growth Factor in Adult Patients with Atopic Dermatitis—A Pilot Study

2022

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Atopic dermatitis (AD) is a chronic, highly pruritic, relapsing–remitting inflammatory skin disease. The etiology of AD has not been fully explained yet and complex interactions of various small molecules are still being taken into account. The aim of this research was to investigate the serum eosinophil-derived neurotoxin (EDN), platelet activating factor (PAF) and vascular endothelial growth factor (VEGF) concentrations in relation to the disease severity and pruritus intensity in adult patients with AD. This pilot study was performed on 30 participants (15 patients with AD and 15 healthy controls). Blood samples were taken to examine the serum levels of EDN, PAF and VEGF using the enzyme-linked immunosorbent assay (ELISA) test. The severity of disease was assessed by the Scoring Atopic Dermatitis (SCORAD) index. The intensity of pruritus, as a subjective symptom, was determined by the Visual Analogue Scale (VAS). Obtained results revealed that the EDN (p = 0.016) and VEGF (p = 0.032), but not PAF (p = 0.841) concentrations were significantly higher in patients with AD compared with those of the control group. There was positive correlation between the EDN level and the SCORAD index in patients with AD (r = −0.9, p = 0.037) which was not found for the PAF and VEGF levels. Circulating EDN, PAF and VEGF levels were not significantly correlated with the severity of pruritus. Our results suggest that the END and VEGF serum levels are significantly increased in patients with AD compared to control group. Moreover, EDN might be useful to reflect the severity of symptoms.

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Itch: Epidemiology, clinical presentation, and diagnostic workup

Cited by 49 publications

References 122 publications

Rapid pruritus reduction with ruxolitinib cream treatment in patients with atopic dermatitis

Rapid pruritus reduction with ruxolitinib cream treatment in patients with atopic dermatitis

Melatonin attenuates acute and chronic itch in mice: the antioxidant and anti-inflammatory effects of melatonin receptors

Serum Levels of Eosinophil-Derived Neurotoxin, Platelet-Activating Factor and Vascular Endothelial Growth Factor in Adult Patients with Atopic Dermatitis—A Pilot Study

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