Neuropathic pain in post‐burn hypertrophic scars: A psychophysical and neurophysiological study

Isoardo, G.; Stella, Maurizio; Cocito, Dario; Risso, Daniela; Migliaretti, Giuseppe; Cauda, Franco; Palmitessa, Angela; Faccani, G.; Ciaramitaro, P.

doi:10.1002/mus.23259

Cited by 28 publications

(31 citation statements)

References 35 publications

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“…4 Patients with these symptoms typically have decreased IENF density in post-burned skin. 5 Similar QST responses to those found by us were shown in hypertrophic skin scars in Letters to the Editor patients after burn injuries 6 and indicate a sensory impairment of small fibre function. Together with the decreased IENF, we have strong indication that our patient presents a typical form of small fibre neuropathy caused by burn injury and skin grafts thereafter including a pathologic reaction towards temperature.…”

supporting

confidence: 72%

A novel mutation of KIT gene results in piebaldism in a Chinese family

Weng

et al. 2014

Acad Dermatol Venereol

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tropical wood was identified as Brazilian rosewood or Dalbergia nigra. The determination was made on the base of a xylotomist, a wood expert who cut slices of the tropical wood and compared them with reference samples. To establish the diagnosis, epicutaneous testing was performed. Results were negative for the allergens included in the basal European and Spanish series. Nevertheless, the patch test with 10% powder of their own bracelet and also Dalbergia nigra in petrolatum was strongly positive (+++) at 48 and 96 h, contrary to the 10 healthy patch tested controls who were negative (Fig. 2).Allergic contact dermatitis to wood (type IV hypersensitivity) usually comes from wood dust while working with it for a long time, causing airborne contact dermatitis that may affect the skin (also non-exposed skin, due to friction and sweating), mucous membranes and/or respiratory tract. Although allergic contact dermatitis from wood is rare, exotic wood from tropical and subtropical regions contains potent allergens (mainly quinones). Moreover, cross-reactivity among exotic woods is common, as their allergens share a similar structure. 1 The benzoquinones present in Dalbergia spp are called dalbergiones and, among them, R-4-methoxydalbergione is a potent sensitizer in Dalbergia nigra. Patch tests with the patient's own products are essential when testing for exotic woods, as standard series do not include specific allergens of these woods. 2-5 Particular identification of the tropical wood allergen is a complex process, either by specialized allergen batteries or by a taxonomist on wood. 6 Hereby we present a case of allergic contact dermatitis caused by a bracelet made of Brazilian rosewood (Dalbergia nigra) out of the occupational environment, a fact scarcely reported in the literature 3-5 but increasing due to the upraising distribution of exotic woods in our environment and therefore clinicians should be aware of it. We emphasize the importance of patch testing with the patient's own product as well as using healthy controls, besides the difficulty of identifying the tropical wood allergenwhich is not done regularly in the daily practice.

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confidence: 72%

A novel mutation of KIT gene results in piebaldism in a Chinese family

Weng

et al. 2014

Acad Dermatol Venereol

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“…The underlying cause of this phenomenon is abnormal nerve fiber function of small fibers (C‐fibers, Ad‐fibers) as demonstrated by quantitative sensory testing (QST). In patients with post‐burn scars and keloids , pathological thermal thresholds reflecting neuropathic sensory dysfunction have been detected by QST. These nerves are very sensible and can be irritated by inflammatory mediators such as nerve growth factor , histamine, serotonin, bradykinin, or prostaglandin .…”

Section: Scarsmentioning

confidence: 99%

Neuropathic itch: diagnosis and management

Stumpf

Ständer

2013

Dermatol Ther

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Chronic pruritus (CP) is a frequent symptom in the general population; in 8% of all patients, it has a neuropathic origin. CP is of neuropathic origin when nerve fiber damage is responsible for the symptom. The damage can be caused by compression or degeneration of the nerve fibers in the skin or extracutaneous in peripheral nerves or the central nervous system. There are significant differences in the pathogenesis and in the clinical presentation of neuropathic CP. Localized neuropathic CP such as brachioradial pruritus or notalgia paresthetica are due to a circumscribed nerve compression and are often limited on the corresponding dermatome. In contrast, generalized neuropathic CP, as in small fiber neuropathies, may be associated with a systemic or metabolic underlying disease. It is not always easy to establish the diagnosis because a variety of diseases can be responsible for this type of CP. The present study shows an overview of possible diseases, diagnostic tools, and the relevant therapy strategies.

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“…6 Multiple mechanisms exist by which a burn scar could cause neuropathic pain. 7 Nerve entrapment within the scar tissue and neuroma formation are important in the pathogenesis of burn scar neuropathy. Studies of nerve fibers in burn patients with chronic pain revealed an increase in nociceptive nerve fibers in burn scars.…”

mentioning

confidence: 99%