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Related Experiment Videos

Itch: scratching more than the surface.

R Twycross1, M W Greaves, H Handwerker

  • 1Sir Michael Sobell House, Churchill Hospital, Oxford, OX3 7LJ, UK. robtwy@yahoo.com

QJM : Monthly Journal of the Association of Physicians
|January 2, 2003
PubMed
Summary
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Itch originates from various sources, including skin, nerves, and systemic diseases. Effective treatments vary, with antihistamines useful for some conditions but not others, necessitating diverse therapeutic strategies.

Area of Science:

  • Dermatology
  • Neurology
  • Pharmacology

Background:

  • Itch (pruritus) has diverse origins: cutaneous, neuropathic, neurogenic, mixed, and psychogenic.
  • Cutaneous itch shares pathways with pain but involves distinct C-fibers responsive to pruritogens, not mechanical stimuli.
  • Histamine is key in insect bites and urticaria, responding to H(1)-antihistamines, but less effective in most dermatoses and systemic diseases.

Purpose of the Study:

  • To review the origins of itch and the efficacy of various pharmacological and non-pharmacological treatments.
  • To highlight the limitations of traditional treatments like H(1)-antihistamines in certain itch conditions.
  • To explore alternative therapies for refractory pruritus.

Main Methods:

  • Literature review of itch pathophysiology and treatment modalities.

Related Experiment Videos

  • Analysis of drug efficacy based on itch origin and mediators.
  • Evaluation of non-pharmacological interventions like Ultraviolet B (UVB) therapy.

    • Main Results:

    • H(1)-antihistamines are effective for histamine-mediated itch (e.g., urticaria) but not for most dermatoses or systemic pruritus.
    • Opioid antagonists and ondansetron show efficacy for specific types of itch (e.g., spinal opioids, cholestasis).
    • Various drugs (rifampicin, thalidomide, paroxetine, etc.) and narrow-band UVB therapy are effective for specific conditions like cholestasis, uraemia, and paraneoplastic itch.

    Conclusions:

    • Itch management requires a tailored approach based on its underlying cause.
    • Diverse pharmacological agents and therapies like UVB are crucial for treating refractory pruritus.
    • Further research into distinct itch pathways can lead to more targeted and effective treatments.