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Hydroxyethylstarch deposits in human skin--a model for pruritus?
W Jurecka1, Z Szépfalusi, E Parth
1Department of Dermatology II, University of Vienna, Austria.
Archives of Dermatological Research
|January 1, 1993
Summary
Hydroxyethylstarch (HES) administration can cause severe itching. HES was found stored in skin cells, particularly macrophages, suggesting these cells release mediators responsible for pruritus.
Area of Science:
- Dermatology
- Pharmacology
- Pathology
Background:
- Hydroxyethylstarch (HES) is used in hemodilution therapy.
- Patients treated with HES can experience severe, unexplained itching.
- HES administration leads to vacuoles in various organs, indicating phagocytosis.
Purpose of the Study:
- To investigate HES deposition in the skin of patients experiencing post-HES itching.
- To identify the cells involved in HES storage in the skin.
- To explore the mechanism behind HES-induced pruritus.
Main Methods:
- Analysis of skin biopsies from patients with HES-induced itching.
- Light and electron microscopy for morphological assessment.
- Immunohistochemistry and immunoelectron microscopy using anti-HES antiserum.
Main Results:
- HES storage was confirmed in the skin of all investigated patients.
- HES was primarily found in dermal macrophages, endothelial cells, and some nerve and skin cells.
- Absence of mast cell degranulation suggests non-histamine mediators cause itching.
Conclusions:
- The skin is a target organ for HES deposition.
- Macrophages and other skin cells store HES, implicating them in pruritus development.
- Non-histamine mediators released from HES-affected cells likely induce itching.