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Itch in Atopic Dermatitis Management.

Yayoi Kamata, Mitsutoshi Tominaga, Kenji Takamori

    Current Problems in Dermatology
    |September 1, 2016
    PubMed
    Summary

    Managing chronic itch in atopic dermatitis (AD) requires new treatments. Current therapies include topical anti-inflammatories, phototherapy, and systemic drugs, with emerging options targeting the central nervous system for itch relief.

    Area of Science:

    • Dermatology
    • Immunology
    • Neuroscience

    Background:

    • Atopic dermatitis (AD) is characterized by chronic inflammation and severe itch resistant to antihistamines.
    • Intractable pruritus in AD significantly impacts patient quality of life, necessitating novel therapeutic strategies.
    • Current standard treatments include topical corticosteroids, calcineurin inhibitors, emollients, and phototherapy.

    Purpose of the Study:

    • To review and describe current and emerging therapeutic approaches for managing intractable itch in atopic dermatitis.
    • To highlight the importance of developing new antipruritic treatments for AD patients.

    Main Methods:

    • Review of existing literature on atopic dermatitis treatments.
    • Discussion of standard therapies: topical anti-inflammatories, emollients, phototherapy.

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  • Exploration of systemic treatments (cyclosporine A, aprepitant) and novel biologics (dupilumab, CIM331).
  • Consideration of emerging central nervous system-targeted approaches.

    • Main Results:

    • Standard treatments offer partial relief, but intractable itch persists in many AD patients.
    • Phototherapy demonstrates efficacy by reducing nerve fibers and inhibiting pruritus.
    • Systemic agents and biologics like dupilumab show significant pruritus reduction in clinical trials.
    • New antipruritic strategies are being developed, focusing on central nervous system targets.

    Conclusions:

    • Effective management of intractable itch in atopic dermatitis requires a multi-faceted approach.
    • Advancements in systemic and biologic therapies, alongside novel CNS-targeted treatments, offer promising avenues for itch relief in AD.
    • Continued research into the mechanisms of pruritus in AD is crucial for developing more effective antipruritic therapies.