Clinical presentation, management, and pathophysiology of neuropathic itch

• Verfasst von: Steinhoff, Martin [VerfasserIn]
• Verfasst von: Schmelz, Martin [VerfasserIn]
• Verfasst von: Szabó, Imre Lőrinc [VerfasserIn]
• Verfasst von: Oaklander, Anne Louise [VerfasserIn]
• Titel: Clinical presentation, management, and pathophysiology of neuropathic itch
• Verf.angabe: Martin Steinhoff, Martin Schmelz, Imre Lőrinc Szabó, Anne Louise Oaklander
• E-Jahr: 2018
• Jahr: August 01, 2018
• Umfang: 12 S.
• Fussnoten: Gesehen am 14.04.2020
• Titel Quelle: Enthalten in: The lancet
• Ort Quelle: London : Lancet Publ. Group, 2002
• Jahr Quelle: 2018
• Band/Heft Quelle: 17(2018), 8, Seite 709-720
• ISSN Quelle: 1474-4465
• DOI: doi:10.1016/S1474-4422(18)30217-5
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1694457753

Abstract

Summary: Unlike conventional itch, neuropathic itch develops in normal skin from excess peripheral firing or dampened central inhibition of itch pathway neurons. Neuropathic itch is a symptom of the same central and peripheral nervous system disorders that cause neuropathic pain, such as sensory polyneuropathy, radiculopathy, herpes zoster, stroke, or multiple sclerosis, and lesion location affects symptoms more than aetiology. The causes of neuropathic itch are heterogeneous, and thus diagnosis is based primarily on recognising characteristic, disease-specific clinical presentations. However, the diagnosis of neuropathic itch is challenging, different subforms exist (eg, focal <i>vs</i> widespread, peripheral <i>vs</i> central), and the mechanisms of neuropathic itch are poorly understood, resulting in reduced treatment availability. Currently available strategies include treating or preventing causal diseases, such as diabetes or herpes zoster, and topical or systemic medications that calm excess neuronal firing. Discovery of itch mediators such as gastrin releasing peptide, receptors (eg, neurokinin-1), and pathways (eg, Janus kinases) might encourage much needed new research into targeted treatments of neuropathic itch.