Prurito crónico
PDF
PubMed (Inglés)

Archivos suplementarios

XML

Palabras clave

Chronic pruritus
Itching
Dermatosis

Resumen

El prurito crónico se define como una sensación no placentera de la piel que induce el rascado y que dura más de seis semanas. Este síntoma puede ser la manifestación de una enfermedad cutánea o sistémica y compromete la calidad de vida de los pacientes, alterando de forma consistente el sueño y las actividades diarias. La fisiopatología es compleja e incluye múltiples mediadores y sus respectivos receptores, que a través de diferentes vías de señalización llevan información por las fibras nerviosas tipo C hacia el tálamo, desde donde se distribuye a diversas zonas de la corteza cerebral. La comprensión de estos mecanismos ha permitido identificar posibles blancos terapéuticos y el desarrollo de moléculas cada vez más efectivas y seguras para los pacientes. La presente revisión pretende dar una visión acerca del manejo diagnóstico y terapéutico de los pacientes con prurito crónico.

PDF
PubMed (Inglés)

Referencias

Weisshaar E, Szepietowski JC, Darsow U, Misery L, Wallengren J, Mettang T, et al. European guideline on chronic pruritus. Acta Derm Venereol. 2012;92(5):563-581. DOI: 10.2340/00015555-1400

Weisshaar E. Epidemiology of itch. Curr Probl Dermatol. 2016;50:5-10. DOI: 10.1159/000446010

Kini S, DeLong L, Veledar E, McKenzie-Brown AM, Schaufele M, Chen S. The impact of pruritus on quality of life: the skin equivalent of pain. Arch Dermatol. 2011;147(10):1153-1156. DOI: 10.1001/archdermatol.2011.178

Warlich B, Fritz F, Osada N, Bruland P, Stumpf A, Schneider G, et al. Health-related quality of life in chronic pruritus: an analysis related to disease etiology, clinical skin conditions and itch intensity. Dermatology. 2015;231(3):253-259. DOI: 10.1159/000437206

Ständer S, Weisshaar E, Mettang T, Szepietowski JC, Carstens E, Ikoma A, et al. Clinical classification of itch: a position paper of the International Forum for the Study of Itch. Acta Derm Venereol. 2007;87(4):291-294. DOI: 10.2340/00015555-0305

Weisshaar E, Dalgard F. Epidemiology of itch: adding to the burden of skin morbidity. Acta Derm Venereol. 2009;89(4):339-350. DOI: 10.2340/00015555-0662

Dalgard F, Svensson A, Holm JØ, Sundby J. Self-reported skin morbidity in Oslo: associations itch sociodemographic factors among adults in a cross-sectional study. Br J Dermatol. 2004;151(2):452-457. DOI: 10.1111/j.1365-2133.2004.06058.x

Matterne U, Apfelbacher CJ, Loerbroks A, Schwarzer T, Büttner M, Ofenloch R, et al. Prevalence, correlates and characteristics of chronic pruritus: a population-based cross-sectional study. Acta Derm Venereol. 2011;91(6):674-679. DOI: 10.2340/00015555-1159

Weisshaar E, Diepgen TL, Luger TA, Seeliger S, Witteler R, Ständer S. Pruritus in pregnancy and childhood: do we really consider all relevant differential diagnoses? Eur J Dermatol. 2005;15(5):320-331.

Staab D, Diepgen TL, Fartasch M, Kupfer J, Lob-Corzilius T, Ring J, et al. Age related, structured educational programmes for the management of atopic dermatitis in children and adolescents: multicentre, randomised controlled trial. BMJ. 2006;332(7547):933-938. DOI: 10.1136/bmj.332.7547.933

Weisshaar E, Diepgen TL, Bruckner T, Fartasch M, Kupfer J, Lob-Corzilius T, et al. Itch intensity evaluated in the German Atopic Dermatitis Intervention Study (GADIS): correlations with quality of life, coping behaviour and SCORAD severity in 823 children. Acta Derm Venereol. 2008;88(3):234-239. DOI: 10.2340/00015555-0432

Ambros-Rudolph CM, Müllegger RR, Vaughan-Jones SA, Kerl H, Black MM. The specific dermatoses of pregnancy revisited and reclassified: results of a retrospective two-center study on 505 pregnant patients. J Am Acad Dermatol. 2006;54(3):395-404. DOI: 10.1016/j.jaad.2005.12.012

Berger TG, Steinhoff M. Pruritus in elderly patients: eruptions of senescence. Semin Cutan Med Surg. 2011;30(2):113-117. DOI: 10.1016/j.sder.2011.04.002

Yalçin B, Tamer E, Toy GG, Oztaş P, Hayran M, Alli N. The prevalence of skin diseases in the elderly: analysis of 4099 geriatric patients. Int J Dermatol. 2006;45(6):672-676. DOI: 10.1111/j.1365-4632.2005.02607.x

Farage MA, Miller KW, Berardesca E, Maibach HI. Clinical implications of aging skin: cutaneous disorders in the elderly. Am J Clin Dermatol. 2009;10(2):73-86. DOI: 10.2165/00128071-200910020-00001

Yosipovitch G, Goon AT, Wee J, Chan YH, Zucker I, Goh CL. Itch characteristics in Chinese patients with atopic dermatitis using a new questionnaire for the assessment of pruritus. Int J Dermatol. 2002;41(4):212-216. DOI: 10.1046/j.1365-4362.2002.01460.x

Szepietowski JC, Reich A, Wisnicka B. Pruritus and psoriasis. Br J Dermatol. 2004;151(6):1284. DOI: 10.1111/j.1365-2133.2004.06299.x

Szepietowski JC, Salomon J. Uremic pruritus: still an important clinical problem. J Am Acad Dermatol. 2004;51(5):842-843. DOI: 10.1016/j.jaad.2004.04.003:

Ständer S. Classification of Itch. Curr Probl Dermatol. 2016;50:1-4. DOI: 10.1159/000446009

Kimmel M, Alscher DM, Dunst R, Braun N, Machleidt C, Kiefer T, et al. The role of micro-inflammation in the pathogenesis of uraemic pruritus in haemodialysis patients. Nephrol Dial Transplant. 2006;21(3):749-755. DOI: 10.1093/ndt/gfi204

Blachley JD, Blankenship DM, Menter A, Parker TF, Knochel JP. Uremic pruritus: skin divalent ion content and response to ultraviolet phototherapy. Am J Kidney Dis. 1985;5(5):237-241. DOI: 10.1016/S0272-6386(85)80115-3

Dugas-Breit S, Schöpf P, Dugas M, Schiffl H, Ruëff F, Przybilla B. Baseline serum levels of mast cell tryptase are raised in hemodialysis patients and associated with severity of pruritus. J Dtsch Dermatol Ges. 2005;3(5):343-347. DOI: 10.1111/j.1610-0387.2005.05706.x

Wikström B, Gellert R, Ladefoged SD, Danda Y, Akai M, Ide K, et al. Kappa-opioid system in uremic pruritus: multicenter, randomized, double-blind, placebo-controlled clinical studies. J Am Soc Nephrol. 2005;16(12):3742-3747. DOI: 10.1681/ASN.2005020152

Duque MI, Thevarajah S, Chan YH, Tuttle AB, Freedman BI, Yosipovitch G. Uremic pruritus is associated with higher Kt/V and serum calcium concentration. Clin Nephrol. 2006;66(3):184-191. DOI: 10.5414/CNP66184

Bergasa NV. The pruritus of cholestasis. J Hepatol. 2005;43(6):1078-1088.

Jabbour SA. Cutaneous manifestations of endocrine disorders: a guide for dermatologists. Am J Clin Dermatol. 2003;4(5):315-331. DOI: 10.2165/00128071-200304050-00003

Gelfand JM, Rudikoff D. Evaluation and treatment of itching in HIV-infected patients. Mt Sinai J Med. 2001;68(4-5):298-308.

Krajnik M, Zylicz Z. Pruritus in advanced internal diseases. Pathogenesis and treatment. Neth J Med. 2001;58(1):27-40.

Pieri L, Bogani C, Guglielmelli P, Zingariello M, Rana RA, Bartalucci N, et al. The JAK2V617 mutation induces constitutive activation and agonist hypersensitivity in basophils from patients with polycythemia vera. Haematologica. 2009;94(11):1537-1545. DOI: 10.3324/haematol.2009.007047

Reich A, Ständer S, Szepietowski JC. Drug-induced pruritus: a review. Acta Derm Venereol. 2009;89(3):236-244. DOI: 10.2340/00015555-0650

Bond LD, Keough GC. Neurogenic pruritus: a case of pruritus induced by transverse myelitis. Br J Dermatol. 2003;149(1):204-205. DOI: 10.1046/j.1365-2133.2003.05388.x

Ellis C. Notalgia paresthetica: the unreachable itch. Dermatol Pract Concept. 2013;3(1):3-6. DOI: 10.5826/dpc.0301a02

Kimsey LS. Delusional infestation and chronic pruritus: a review. Acta Derm Venereol. 2016;96:298-302. DOI: 10.2340/00015555-2236

Rajagopalan M, Saraswat A, Godse K, Shankar DS, Kandhari S, Shenoi S, et al. Diagnosis and management of chronic pruritus: an expert consensus review. Indian J Dermatol. 2017;62(1):7-17. DOI: 10.4103/0019-5154.198036

Dhand A, Aminoff MJ. The neurology of itch. Brain. 2014;137(Pt 2):313-322. DOI: 10.1093/brain/awt158

Liu T, Ji RR. New insights into the mechanisms of itch: are pain and itch controlled by distinct mechanisms? Pflugers Arch. 2013;465(12):1671-1685. DOI: 10.1007/s00424-013-1284-2

Meng J, Steinhoff M. Molecular mechanisms of pruritus. Curr Res Transl Med. 2016;64(4):203-206. DOI: 10.1016/j.retram.2016.08.006

Johanek LM, Meyer RA, Friedman RM, Greenquist KW, Shim B, Borzan J, et al. A role for polymodal C-fiber afferents in nonhistaminergic itch. J Neurosci. 2008;28(30):7659-7669. DOI: 10.1523/JNEUROSCI.1760-08.2008

Davidson S, Giesler GJ. The multiple pathways for itch and their interactions with pain. Trends Neurosci. 2010;33(12):550-558. DOI: 10.1016/j.tins.2010.09.002

Papoiu AD, Coghill RC, Kraft RA, Wang H, Yosipovitch G. A tale of two itches. Common features and notable differences in brain activation evoked by cowhage and histamine induced itch. Neuroimage. 2012;59(4):3611-3623. DOI: 10.1016/j.neuroimage.2011.10.099

Pereira M, Kremer A, Mettang T, Ständer S. chronic pruritus in the absence of skin disease: pathophysiology, diagnosis and treatment. Am J Clin Dermatol. 2016;17(4):337-348. DOI: 10.1007/s40257-016-0198-0

Yosipovitch G, Bernhard JD. Clinical practice. Chronic pruritus. N Engl J Med. 2013;368(17):1625-1634. DOI: 10.1056/NEJMcp1208814

Ständer S, Pogatzki-Zahn E, Stumpf A, Fritz F, Pfleiderer B, Ritzkat A, et al. Facing the challenges of chronic pruritus: a report from a multi-disciplinary medical itch centre in Germany. Acta Derm Venereol. 2015;95(3):266-271. DOI: 10.2340/00015555-1949

Szepietowski JC, Weisshaar E, editores. Itch–Management in clinical practice. Suiza: Karger; 2016.

Caterina MJ. Transient receptor potential ion channels as participants in thermosensation and thermoregulation. Am J Physiol Regul Integr Comp Physiol. 2007;292(1):R64-R76. DOI: 10.1152/ajpregu.00446.2006

Hautkappe M, Roizen MF, Toledano A, Roth S, Jeffries JA, Ostermeier AM. Review of the effectiveness of capsaicin for painful cutaneous disorders and neural dysfunction. Clin J Pain. 1998;14(2):97-106.

Misery L, Erfan N, Castela E, Brenaut E, Lantéri-Minet M, Lacour JP, et al. Successful treatment of refractory neuropathic pruritus with capsaicin 8 % patch: a bicentric retrospective study with long-term follow-up. Acta Derm Venereol. 2015;95(7):864-865. DOI: 10.2340/00015555-2085

Zeidler C, Lüling H, Dieckhöfer A, Osada N, Schedel F, Steinke S, et al. Capsaicin 8 % cutaneous patch: a promising treatment for brachioradial pruritus? Br J Dermatol. 2015;172(6):1669-1671. DOI: 10.1111/bjd.13501

Bauer M, Schwameis R, Scherzer T, Lang-Zwosta I, Nishino K, Zeitlinger M, et al. A double-blind, randomized clinical study to determine the efficacy of benzocaine 10 % on histamine-induced pruritus and UVB-light induced slight sunburn pain. J Dermatolog Treat. 2015;26(4):367-372. DOI: 10.3109/09546634.2014.992384

Young TA, Patel TS, Camacho F, Clark A, Freedman BI, Kaur M, et al. A pramoxine-based anti-itch lotion is more effective than a control lotion for the treatment of uremic pruritus in adult hemodialysis patients. J Dermatolog Treat. 2009;20(2):76-81. DOI: 10.1080/09546630802441218

Kawashima M, Tango T, Noguchi T, Inagi M, Nakagawa H, Harada S. Addition of fexofenadine to a topical corticosteroid reduces the pruritus associated with atopic dermatitis in a 1-week randomized, multicentre, double-blind, placebo-controlled, parallel-group study. Br J Dermatol. 2003;148(6):1212-1221. DOI: 10.1046/j.1365-2133.2003.05293.x

Fleischer AB, Boguniewicz M. An approach to pruritus in atopic dermatitis: a critical systematic review of the tacrolimus ointment literature. J Drugs Dermatol. 2010;9(5):488-498.

Simpson D, Noble S. Tacrolimus ointment: a review of its use in atopic dermatitis and its clinical potential in other inflammatory skin conditions. Drugs. 2005;65(6):827-858. DOI: 10.2165/00003495-200565060-00011

Papp KA, Papp A, Dahmer B, Clark CS. Single-blind, randomized controlled trial evaluating the treatment of facial seborrheic dermatitis with hydrocortisone 1 % ointment compared with tacrolimus 0.1 % ointment in adults. J Am Acad Dermatol. 2012;67(1):e11-e15. DOI: 10.1016/j.jaad.2011.02.032

Kuhn A, Gensch K, Haust M, Schneider SW, Bonsmann G, Gaebelein-Wissing N, et al. Efficacy of tacrolimus 0.1 % ointment in cutaneous lupus erythematosus: a multicenter, randomized, double-blind, vehicle-controlled trial. J Am Acad Dermatol. 2011;65(1):54-64. DOI: 10.1016/j.jaad.2010.03.037

Suys E. Randomized study of topical tacrolimus ointment as possible treatment for resistant idiopathic pruritus ani. J Am Acad Dermatol. 2012;66(2):327-328. DOI: 10.1016/j.jaad.2011.05.024

Ständer S, Weisshaar E, Luger TA. Neurophysiological and neurochemical basis of modern pruritus treatment. Exp Dermatol. 2008;17(3):161-169. DOI: 10.1111/j.1600-0625.2007.00664.x

Sugawara K, Bíró T, Tsuruta D, Tóth BI, Kromminga A, Zákány N, et al. Endocannabinoids limit excessive mast cell maturation and activation in human skin. J Allergy Clin Immunol. 2012;129(3):726-738. DOI: 10.1016/j.jaci.2011.11.009

Eberlein B, Eicke C, Reinhardt HW, Ring J. Adjuvant treatment of atopic eczema: assessment of an emollient containing N-palmitoylethanolamine (ATOPA study). J Eur Acad Dermatol Venereol. 2008;22(1):73-82. DOI: 10.1111/j.1468-3083.2007.02351.x

Green BG, Schoen KL. Thermal and nociceptive sensations from menthol and their suppression by dynamic contact. Behav Brain Res. 2007;176(2):284-291. DOI: 10.1016/j.bbr.2006.10.013

O’Donoghue M, Tharp MD. Antihistamines and their role as antipruritics. Dermatol Ther. 2005;18(4):333-340. DOI: 10.1111/j.1529-8019.2005.00034.x

Asero R. Chronic unremitting urticaria: is the use of antihistamines above the licensed dose effective? A preliminary study of cetirizine at licensed and above-licensed doses. Clin Exp Dermatol. 2007;32(1):34-38. DOI: 10.1111/j.1365-2230.2006.02278.x

Schulz S, Metz M, Siepmann D, Luger TA, Maurer M, Ständer S. Antipruritische Wirksamkeit einer Hochdosierten Antihistaminika-Therapie: Ergebnisse Einer Retrospektiv Analysierten Fallserie. Hautarzt. 2009;60(7):564-568.

Phan NQ, Bernhard JD, Luger TA, Ständer S. Antipruritic treatment with systemic μ-opioid receptor antagonists: a review. J Am Acad Dermatol. 2010;63(4):680-688. DOI: 10.1016/j.jaad.2009.08.052

Phan NQ, Lotts T, Antal A, Bernhard JD, Ständer S. Systemic kappa opioid receptor agonists in the treatment of chronic pruritus: a literature review. Acta Derm Venereol. 2012;92(5):555-560. DOI: 10.2340/00015555-1353

Dawn AG, Yosipovitch G. Butorphanol for treatment of intractable pruritus. J Am Acad Dermatol. 2006;54(3):527-531. DOI: 10.1016/j.jaad.2005.12.010

Foroutan N, Nikvarz N. Role of pregabalin in management of pruritus: a literature review. J Pharm Pharm Sci. 2016;19(4):465-474. DOI: 10.18433/J35K6N

Vila T, Gommer J, Scates AC. Role of gabapentin in the treatment of uremic pruritus. Ann Pharmacother. 2008;42(7):1080-1084. DOI: 10.1345/aph.1L038

Razeghi E, Eskandari D, Ganji MR, Meysamie AP, Togha M, Khashayar P. Gabapentin and uremic pruritus in hemodialysis patients. Ren Fail. 2009;31(2):85-90. DOI: 10.1080/08860220802595476

Paus R, Schmelz M, Bíró T, Steinhoff M. Frontiers in pruritus research: scratching the brain for more effective itch therapy. J Clin Invest. 2006;116(5):1174-1186. DOI: 10.1172/JCI28553

Hundley JL, Yosipovitch G. Mirtazapine for reducing nocturnal itch in patients with chronic pruritus: a pilot study. J Am Acad Dermatol. 2004;50(6):889-891. DOI: 10.1016/j.jaad.2004.01.045

Wahlgren CF, Scheynius A, Hägermark O. Antipruritic effect of oral cyclosporin A in atopic dermatitis. Acta Derm Venereol. 1990;70(4):323-329.

Siepmann D, Luger TA, Ständer S. Antipruritic effect of cyclosporine microemulsion in prurigo nodularis: results of a case series. J Dtsch Dermatol Ges. 2008;6(11):941-946. DOI: 10.1111/j.1610-0387.2008.06745.x

Fusaro M, Munaretto G, Spinello M, Gallieni M. Regression of uraemic pruritus by cyclosporin treatment in a haemodialysis patient. Nephrol Dial Transplant. 2004;19(5):1338-1339. DOI: 10.1093/ndt/gfh131

Maley A, Swerlick RA. Azathioprine treatment of intractable pruritus: A retrospective review. J Am Acad Dermatol. 2015;73(3):439-443. DOI: 10.1016/j.jaad.2015.05.025

Vincenzi B, Fratto ME, Santini D, Tonini G. Aprepitant against pruritus in patients with solid tumours. Support Care Cancer. 2010;18(9):1229-1230. DOI: 10.1007/s00520-010-0895-9

Booken N, Heck M, Nicolay JP, Klemke CD, Goerdt S, Utikal J. Oral aprepitant in the therapy of refractory pruritus in erythrodermic cutaneous T-cell lymphoma. Br J Dermatol. 2011;164(3):665-667. DOI: 10.1111/j.1365-2133.2010.10108.x

Ständer S, Siepmann D, Herrgott I, Sunderkötter C, Luger TA. Targeting the neurokinin receptor 1 with aprepitant: a novel antipruritic strategy. PLoS One. 2010;5(6):e10968. DOI: 10.1371/journal.pone.0010968

Rivard J, Lim HW. Ultraviolet phototherapy for pruritus. Dermatol Ther. 2005;18(4):344-354. DOI: 10.1111/j.1529-8019.2005.00032.x

Wallengren J, Sundler F. Phototherapy reduces the number of epidermal and CGRP-positive dermal nerve fibres. Acta Derm Venereol. 2004;84(2):111-115. DOI: 10.1080/00015550310022899

Seckin D, Demircay Z, Akin O. Generalized pruritus treated with narrowband UVB. Int J Dermatol. 2007;46(4):367-370. DOI: 10.1111/j.1365-4632.2007.03048.x

Creative Commons License

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.

Derechos de autor 2019 Revista Alergia México

Descargas

##plugins.themes.healthSciences.displayStats.noStats##