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This blue-ribbon reference compiles the latest research and recommendations from leading specialists in the field to offer a concise and multidisciplinary discussion of the basic aspects of itch, diseases in which itch serves as a major component, and recent procedures for the assessment and control of itch in patient care. Provides a detailed and multidimensional overview of itch pathophysiology, as well as current treatment regimens, new approaches to itch control, and examinations of clinical trials in progress.
This issue of Dermatologic Clinics, guest edited by Dr. Gil Yosipovitch, is devoted to Pruritus (Itch). Articles in this issue include: Pathophysiology of Chronic Itch; Work-up of Chronic Itchy Patient; Management of Prurigo Nodularis; Chronic Pruritus in the Geriatric Population; Diagnosis and Management of Neuropathic Itch; Female Genital Itch; End Stage Renal Disease Chronic Itch and its Management; Management of Chronic Hepatic Itch; Pruritus in Scabies; Pruritus Associated with Targeted Cancer Therapies and Their Management; Pruritus in Lymphoma and its Management; Pruritus in Pregnancy and its Management; Pruritus in Connective Tissue Disorders; Immunomodulating Agents as Anti Pruritics; Psychogenic Pruritus and its Management; and Drugs on the Horizon for Chronic Itch.
Basic research on the pharmacology of itch has exploded in the wake of two very influential papers that were published in Nature (2007) and Science (2009). Long overlooked as a milder form of pain, itching has rapidly gained a new appreciation in both research and clinical communities because of its complexity and its negative effects on the quality of life of the distressed patients. Like pain, not all itches are the same. Unlike pain, there are no standard drugs equivalent to aspirin and morphine. Epidemiological studies emphasize the high incidence and economic costs of itch (pruritus). It is the most prevalent symptom of a wide variety of allergic and inflammatory skin conditions (e.g., psoriasis, atopic dermatitis), is associated with several systemic diseases (e.g., chronic kidney and liver disease), and occurs in patients undergoing hemodialysis, spinal administration of opioids, and in those suffering from AIDS. The reader will learn about the multiple pathways for itch and their interactions with pain. The relationship between these closely related, yet distinct sensory phenomena, will be emphasized. Both itch and pain use several common molecules to send signals to the brain. Thus, drugs that have been, and are being, developed as analgesics may also attenuate intractable itch. This has been an exciting and very necessary turn of events since traditional H-1 receptor antagonists are ineffective in blocking the pruritus associated with kidney failure and cholestasis. The clinical chapters will provide insights into contemporary treatment regimens for pruritus in different human scenarios.
We have all experienced itch, whether from insect bites or dry skin, but millions of people worldwide have chronic or even intractable itch. Just like chronic pain, chronic itch interferes with a person's ability to function-and even affects quality of life. Living with Itch offers relief, drawing on the authors' vast knowledge of itch, the suffering it causes, and available treatments. Itch researchers and clinicians Drs. Gil Yosipovitch and Shawn G. Kwatra explain the cascade of physiological events that causes us to experience itch. They describe the many skin diseases, from atopic dermatitis (eczema) to psoriasis, and conditions like chronic kidney disease, lymphoma, HIV, and neuropathies that cause itch. Living with Itch provides information on preventing itch as well as topical and systemic ways to treat it. Patient and parent narratives illustrate how people cope with itch and how, with medical and social support, itch can be managed.
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