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Published on: February 13, 2018
Pruritus: an underrecognized symptom of small-fiber neuropathies
Emilie Brenaut1, Pascale Marcorelles2, Steeve Genestet3
1Department of Dermatology, University Hospital, Brest, France; Laboratory of Neurosciences of Brest, University of Western Brittany, Brest, France.
Background:
Small-fiber neuropathies (SFN) are diseases of small nerve fibers that are characterized by autonomic and sensory symptoms.
Objective:
We sought to evaluate sensory symptoms, especially pruritus, in patients with SFN.
Methods:
A questionnaire was given to patients with SFN.
Results:
In all, 41 patients responded to the questionnaire (71.9% response rate). The most frequent sensory symptoms were burning (77.5%), pain (72.5%), heat sensations (70.2%), and numbness (67.5%). Pruritus was present in 68.3% of patients. It appeared most often in the evening, and was localized to the limbs in a distal-to-proximal gradient, although the back was the most frequent location (64%). Exacerbating factors were fatigue, xerosis, sweating, hot temperature, and stress. Cold water was an alleviating factor.
Limitations:
Recall bias associated with filling out the questionnaire, relatively small sample size, and the uncontrolled, retrospective nature of the study were limitations.
Conclusion:
Pruritus occurs frequently in patients with SFN and could be recognized as a possible presenting symptom, especially if there are other sensory or autonomic symptoms.
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