Pruritus

Patel, Tejesh; Yosipovitch, Gil

doi:10.1002/9781118590638.ch12

Cited by 2 publications

(6 citation statements)

References 62 publications

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“…Although the mechanism of pruritus with targeted therapies has not yet been determined, understanding the underlying pathophysiology will not only help guide management strategies but may also provide insight as to why the agents discussed here cause this dAE to variable degrees. For example, EGFRIs inhibit their target receptor in normal basal keratinocytes, interfere with cell renewal in the epidermis, and disturb sebaceous and sweat glands . By perturbing normal epidermal physiology, EGFR inhibitors create alterations in the skin barrier that may lead to xerosis .…”

Section: Discussionmentioning

confidence: 99%

“…In order to provide this, clinicians should understand the underlying mechanism and pathophysiology of pruritus induced by targeted agents . Recently, advances have been made to elucidate the neurobiologic pathways and key modulators involved in general pruritus, and pruritus related to systemic diseases , but work is still required to better understand pruritus secondary to targeted therapies.…”

Section: Proposed Mechanisms and Pathophysiologymentioning

confidence: 99%

“…Regardless of the underlying cause for pruritus with targeted therapies, patients often require a tailored approach. Lifestyle modifications include keeping finger nails short to avoid exacerbation of the frustrating “itch‐scratch” cycle, and keeping cool with loose and light clothing, air‐conditioning, and tepid showers, as warmth intensifies the itch sensation . Most importantly, patients receiving these cancer treatments should be warned of the risks of developing pruritus, and educated regarding their management options.…”

Section: Treatment Recommendations and Current Management Guidelinesmentioning

confidence: 99%

“…) usually begins with topical therapies for grades 1–2, but systemic treatments are often necessary for grade 3 or intolerable (persistent) grade 2 . Applying cold compresses and wet dressings, along with topical corticosteroids, relieves irresistible pruritus in some patients , especially those with an associated inflammatory component . Generalized pruritus is often managed with systemic antihistamines, which, although known to provide symptomatic relief to patients with chronic urticaria, have demonstrated conflicting results in other pruritic disorders , and in the targeted‐therapy setting , supporting the fact that itch secondary to EGFRIs and vemurafenib may be mediated by non‐histamine neurotransmitters .…”

Section: Treatment Recommendations and Current Management Guidelinesmentioning

confidence: 99%

“…The tricyclic antidepressant doxepin, which is also a potent histamine antagonist, has been utilized to relieve general pruritus in both topical and oral preparations , and may be of benefit in patients receiving EGFRIs, vemurafenib, and ipilimumab as well. Importantly, special caution should be taken when giving antihistamines to cancer patients, especially those who are elderly, as they may already be prescribed sedating medications .…”

Section: Treatment Recommendations and Current Management Guidelinesmentioning

confidence: 99%

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Pruritus to anticancer agents targeting the EGFR, BRAF, and CTLA-4

et al. 2013

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In the past decade, the expanded use of targeted anticancer drugs has significantly prolonged survival in patients treated for a variety of cancers. Despite their increased specificity, agents such as epidermal growth factor receptor inhibitors (EGFRIs), BRAF inhibitors, and targeted immunotherapies have commonly been associated with a number of dermatologic adverse events, often necessitating treatment modifications and negatively impacting patients' quality of life. Although toxicities such as rash and xerosis are frequently discussed, symptomatic pruritus, or itch, has emerged as an important, and frequently neglected, event. The present study reviews the incidence and clinical presentation of pruritus with the EFGRIs, and with two novel anti-melanoma drugs, vemurafenib and ipilimumab, with a focus on the putative underlying pathophysiology, and current management strategies.

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Section: Discussionmentioning

confidence: 99%

Section: Proposed Mechanisms and Pathophysiologymentioning

confidence: 99%

Section: Treatment Recommendations and Current Management Guidelinesmentioning

confidence: 99%

Section: Treatment Recommendations and Current Management Guidelinesmentioning

confidence: 99%

Section: Treatment Recommendations and Current Management Guidelinesmentioning

confidence: 99%

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Pruritus to anticancer agents targeting the EGFR, BRAF, and CTLA-4

et al. 2013

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Northern fowl mite infestation affects the nocturnal behavior of laying hens

Jacobs

Vezzoli

Beerda

et al. 2019

Applied Animal Behaviour Science

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The northern fowl mite (Ornithonyssus sylviarum) is a key pest for caged laying hens. High infestation levels can lead to anemia, reduced production, and mortality. Although the mites cause skin irritation and thus likely affect resting behavior, the nocturnal behavior of infested chickens has not yet been studied. We investigated the impact of mite infestation on nighttime behavior of 16 beak-trimmed White Leghorn hens. The hens were housed individually in wire cages. They were experimentally inoculated with approximately 35 mites at 25 weeks of age and observed for the behaviors dozing, sleeping, preening and being active. Continuous observations were made from video recordings taken from 22:00 h until 06:00 h for two consecutive nights at pre-infestation week 0 and post-infestation weeks 3, 5 and 7. Mite infestation levels were measured weekly on an 8-point scale (0 (no mites) to 7 (≥10,000 mites per hen)). For statistical analyses with linear mixed models, mite infestation levels were categorized as score 0 (no mites), 3-4 (51-500), 5 (501-1000) and 6-7 (> 1000). Higher levels of mite infestation were associated with hens spending less time dozing (P < 0.001) and more time preening (P < 0.001) and being active (P = 0.012). Dozing decreased from 90% of the observed time for mite score 0 to 76% for score 6-7. Preening increased from 2% (score 0) to 9% (6-7) and time spent being active increased from 1% (0) to 7% (6-7). Mite infestation increased the number of uninterrupted bouts of all behaviors (P ≤ 0.020), especially dozing and preening (P < 0.001), suggesting restlessness in the mite-infested hens due to irritation and itching. The mite-infested hens' increased nocturnal activity, including preening, as well as the fragmentation of behavioral activities together with decreased dozing, indicate disturbed resting behavior and suggest a reduction in the welfare of mite-infested hens.

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Pruritus

Cited by 2 publications

References 62 publications

Pruritus to anticancer agents targeting the EGFR, BRAF, and CTLA-4

Pruritus to anticancer agents targeting the EGFR, BRAF, and CTLA-4

Northern fowl mite infestation affects the nocturnal behavior of laying hens

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