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Post herpetic itching--a treatment dilemma.
Valentina Semionov1, Pesach Shvartzman
1Pain and Palliative Care Unit, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, Clalit Health Services-Southern District, Beer-Sheva, Israel. valsem2002@yahoo.com
The Clinical Journal of Pain
|April 23, 2008
Summary
A severe case of postherpetic itching (PHI) in an immunocompromised patient successfully responded to a combination of antihistamine and antiepileptic treatments. This highlights a potential management strategy for neuropathic itch.
Area of Science:
- Neurology
- Dermatology
- Immunology
Background:
- Postherpetic itching (PHI) is a debilitating complication of herpes zoster ophthalmicus.
- Neuropathic itch can be more treatment-resistant than neuropathic pain.
- Understanding PHI mechanisms is crucial for effective management.
Observation:
- A 22-year-old male with non-Hodgkin lymphoma and chronic renal failure developed severe, disabling pruritus around his left eye post-herpes zoster ophthalmicus.
- The patient reported intense itching (10/10 VAS) with no pain, alongside hyposensitivity to touch in the affected area.
- This case highlights PHI in an immunocompromised individual with significant comorbidities.
Findings:
- The patient experienced successful relief from severe PHI using a combination therapy.
- Treatment involved antihistamines and an antiepileptic agent.
- This suggests a viable therapeutic approach for severe neuropathic itch.
Implications:
- This case demonstrates a potential treatment regimen for severe, disabling postherpetic itching.
- Further research into the mechanisms and optimal treatment of PHI is warranted.
- Management of neuropathic itch in immunocompromised patients may require tailored therapeutic strategies.
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