Neuropathic agents in the management of pruritus in burn injuries: a systematic review and meta-analysis

McGovern, Christopher O.; Quasim, Tara; Puxty, Kathryn; Shaw, Martin; Ng, Wijnand; Gilhooly, Charlotte; Arkoulis, Nikolaos; Basler, Michael; Macfarlane, Alan; Paton, Lia

doi:10.1136/tsaco-2021-000810

Cited by 1 publication

(3 citation statements)

References 82 publications

(128 reference statements)

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“…In one study, it was observed that approximately two-thirds of patients discharged from burn units complained of pruritus. Responses to sensory stimulation on burn-skin grafts were reduced or absent in the vast majority of patients [34]. The majority of patients with keloids also complained of pruritus, especially around the keloid margins [35].…”

Section: Post-burn or Post-surgery Scars And Keloidsmentioning

confidence: 98%

“…Neurophysiological studies have revealed functional abnormalities in small nerve fibers. Scar tissue is prone to prolonged itching and is often characterized by a burning and piercing sensation [33][34][35]. In one study, it was observed that approximately two-thirds of patients discharged from burn units complained of pruritus.…”

Section: Post-burn or Post-surgery Scars And Keloidsmentioning

confidence: 99%

“…The combination of selective serotonin and norepinephrine inhibitor mirtazapine and gabapentin used to treat neuropathic pain may also be beneficial for NP. Kappa opioids, which are particularly beneficial for chronic resistant pruritus, may be effective against NP [11,16,34]. In particular, fMRI studies of butorphanol have been shown to reduce activity in areas of the brain associated with itching activity, such as the claustrum, insula, and putamen [69].…”

Section: Treatment and Management Of Neuropathic Pruritusmentioning

confidence: 99%

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Neuropathic Pruritus: An Underrecognized and Often Misdiagnosed and Difficult to Treat Medical Condition

Akarsu¹

2023

Rare Diseases - Recent Advances

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It is estimated that approximately 8% of chronic pruritic cases are of neuropathic origin. Common neuropathic pruritic syndromes include different clinical presentations such as postherpetic pruritus, trigeminal trophic syndrome, anogenital pruritus, scalp dysesthesia, nerve compression syndromes (e.g., notalgia paresthetica, brachioradial pruritus), small-fiber neuropathy (secondary to various metabolic, infectious, autoimmune, and genetic diseases), and disorders affecting the central nervous system (occupying lesions, iatrogenic, infectious, neurodegenerative, or demyelinating diseases). Although general practitioners are most likely to see the itchy cases first and consider referring them to further medical advice, it would be a better approach for the physicians to cooperate with dermatologists and neurologists and physiotherapists in particular especially in chronic persistent itchy conditions. Neuropathic pruritus must first be differentiated from other possible etiologies of pruritus by medical history and physical examination, laboratory tests, skin biopsy, and radiological and functional evaluations. It often does not respond to classical antipruritic treatments and different treatment options such as neuroleptics, topical capsaicin, epidural steroid injections, botulinum injections, nerve blocks, and neurostimulation techniques have been tried with variable success responses. This chapter provides a comprehensive overview of the characteristics and clinical presentations of neuropathic pruritus and the diagnostic and therapeutic management used in such patients.

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Section: Post-burn or Post-surgery Scars And Keloidsmentioning

confidence: 98%

Section: Post-burn or Post-surgery Scars And Keloidsmentioning

confidence: 99%