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Tóth BI, Szallasi A, Bíró T. Transient receptor potential channels and itch: how deep should we scratch? Handb Exp Pharmacol 2015; 226:89-133. [PMID: 25861776 DOI: 10.1007/978-3-662-44605-8_6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Over the past 30 years, transient receptor potential (TRP) channels have evolved from a somewhat obscure observation on how fruit flies detect light to become the center of drug discovery efforts, triggering a heated debate about their potential as targets for therapeutic applications in humans. In this review, we describe our current understanding of the diverse mechanism of action of TRP channels in the itch pathway from the skin to the brain with focus on the peripheral detection of stimuli that elicit the desire to scratch and spinal itch processing and sensitization. We predict that the compelling basic research findings on TRP channels and pruritus will be translated into the development of novel, clinically useful itch medications.
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Affiliation(s)
- Balázs I Tóth
- DE-MTA "Lendület" Cellular Physiology Research Group, Department of Physiology, University of Debrecen, Debrecen, 4032, Hungary
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Ochi H, Tan L, Tey H. Notalgia paresthetica: treatment with topical tacrolimus. J Eur Acad Dermatol Venereol 2014; 30:452-4. [DOI: 10.1111/jdv.12830] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- H. Ochi
- National Skin Centre; Singapore Singapore
| | - L.X. Tan
- National Skin Centre; Singapore Singapore
| | - H.L. Tey
- National Skin Centre; Singapore Singapore
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Song Y, Wang Z, Wang Z, Zhang H, Li X, Chen B. Use of FK506 and bone marrow mesenchymal stem cells for rat hind limb allografts. Neural Regen Res 2014; 7:2681-8. [PMID: 25337114 PMCID: PMC4200736 DOI: 10.3969/j.issn.1673-5374.2012.34.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 11/29/2012] [Indexed: 01/08/2023] Open
Abstract
Dark Agouti rat donor hind limbs were orthotopically transplanted into Lewis rat recipients to verify the effects of bone marrow mesenchymal stem cells on neural regeneration and functional recovery of allotransplanted limbs in the microenvironment of immunotolerance. bone marrow mesenchymal stem cells were intramuscularly (gluteus maximus) injected with FK506 (tacrolimus) daily, and were transplanted to the injured nerves. Results indicated that the allograft group not receiving therapy showed severe rejection, with transplanted limbs detaching at 10 days after transplantation with complete necrosis. The number of myelinated axons and Schwann cells in the FK506 and FK506 + bone marrow mesenchymal stem cells groups were significantly increased. We observed a lesser degree of gastrocnemius muscle degeneration, and increased polymorphic fibers along with other pathological changes in the FK506 + bone marrow mesenchymal stem cells group. The FK506 + bone marrow mesenchymal stem cells group showed significantly better recovery than the autograft and FK506 groups. The results demonstrated that FK506 improved the immune microenvironment. FK506 combined with bone marrow mesenchymal stem cells significantly promoted sciatic nerve regeneration, and improved sensory recovery and motor function in hind limb allotransplant.
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Affiliation(s)
- Youxin Song
- Department of Orthopedics, Affiliated Hospital of Chengde Medical College, Chengde 067000, Hebei Province, China
| | - Zhujun Wang
- Department of Research, Affiliated Hospital of Chengde Medical College, Chengde 067000, Hebei Province, China
| | - Zhixue Wang
- Department of Anesthesia, Affiliated Hospital of Chengde Medical College, Chengde 067000, Hebei Province, China
| | - Hong Zhang
- Department of Surgery, Affiliated Hospital of Chengde Medical College, Chengde 067000, Hebei Province, China
| | - Xiaohui Li
- Department of Research, Affiliated Hospital of Chengde Medical College, Chengde 067000, Hebei Province, China
| | - Bin Chen
- Department of Orthopedics, Affiliated Hospital of Chengde Medical College, Chengde 067000, Hebei Province, China
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Yang F, Tanaka M, Wataya-Kaneda M, Yang L, Nakamura A, Matsumoto S, Attia M, Murota H, Katayama I. Topical application of rapamycin ointment ameliorates Dermatophagoides farina body extract-induced atopic dermatitis in NC/Nga mice. Exp Dermatol 2014; 23:568-72. [PMID: 24903639 DOI: 10.1111/exd.12463] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2014] [Indexed: 12/24/2022]
Abstract
Atopic dermatitis (AD), a chronic inflammatory skin disease characterized by relapsing eczema and intense prurigo, requires effective and safe pharmacological therapy. Recently, rapamycin, an mTOR (mammalian target of rapamycin) inhibitor, has been reported to play a critical role in immune responses and has emerged as an effective immunosuppressive drug. In this study, we assessed whether inhibition of mTOR signalling could suppress dermatitis in mice. Rapamycin was topically applied to inflamed skin in a murine AD model that was developed by repeated topical application of Dermatophagoides farina body (Dfb) extract antigen twice weekly for 7 weeks in NC/Nga mice. The efficacy of topical rapamycin treatment was evaluated immunologically and serologically. Topical application of rapamycin reduced inflammatory cell infiltration in the dermis, alleviated the increase of serum IgE levels and resulted in a significant reduction in clinical skin condition score and marked improvement of histological findings. In addition, increased mTOR phosphorylation in the lesional skin was observed in our murine AD model. Topical application of rapamycin ointment inhibited Dfb antigen-induced dermatitis in NC/Nga mice, promising a new therapy for atopic dermatitis.
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Affiliation(s)
- Fei Yang
- Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
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Abstract
Pruritus, also known as itch, is a very common, unpleasant sensation that elicits an urge to scratch. Its origin is not always in the skin, and neuropathic itch that is caused by neuronal or glial damage is common, but poorly understood by both dermatologists and neurologists. Although pruritus has not been considered as serious a symptom as pain, it is difficult to treat and--if chronic--can severely impair quality of life. Neuropathic itch is often associated with other clinical symptoms, most commonly neuropathic pain, and hypersensitization to stimuli is present in both pruritus and pain of neuropathic origin. The shared aetiology can aid in finding suitable treatment for itch in some cases, but more detailed knowledge of the mechanisms of itch, along with standardized, well-controlled trials, is needed. Pruritus research is an emerging but currently very active field, and our understanding of this sensation is rapidly increasing. Here, we review new discoveries regarding the role of the nervous system and the contribution of different pathways in pruritus, discuss the different aetiologies of neuropathic itch, and outline currently available and potential strategies for managing neuropathic pruritus.
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Tan E, Tan A, Tey H. Effective treatment of scrotal lichen simplex chronicus with 0.1% tacrolimus ointment: an observational study. J Eur Acad Dermatol Venereol 2014; 29:1448-9. [DOI: 10.1111/jdv.12500] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- E.S. Tan
- National Skin Centre; Singapore Singapore
| | - A.S. Tan
- Annenberg School for Communication; University of Pennsylvania; PA USA
| | - H.L. Tey
- National Skin Centre; Singapore Singapore
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Affiliation(s)
- Laurent Misery
- Laboratoire des neurosciences de Brest (EA4685), Université de Bretagne occidentale, service de dermatologie vénérologie, CHU de Brest, faculté de médecine, rue Camille Desmoulins, 29200 Brest, France
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Lebonvallet N, Pennec JP, Le Gall-Ianotto C, Chéret J, Jeanmaire C, Carré JL, Pauly G, Misery L. Activation of primary sensory neurons by the topical application of capsaicin on the epidermis of a re-innervated organotypic human skin model. Exp Dermatol 2013; 23:73-5. [DOI: 10.1111/exd.12294] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Nicolas Lebonvallet
- Laboratory of Neurosciences of Brest, EA4685; Faculty of Medicine and Health Sciences; University of Brest; Brest France
- BASF Beauty Care Solutions; Pulnoy France
| | - Jean-Pierre Pennec
- Faculty of Medicine and Health Sciences; University of Brest; Brest France
| | - Christelle Le Gall-Ianotto
- Laboratory of Neurosciences of Brest, EA4685; Faculty of Medicine and Health Sciences; University of Brest; Brest France
| | - Jérémy Chéret
- Laboratory of Neurosciences of Brest, EA4685; Faculty of Medicine and Health Sciences; University of Brest; Brest France
| | | | - Jean-Luc Carré
- Laboratory of Neurosciences of Brest, EA4685; Faculty of Medicine and Health Sciences; University of Brest; Brest France
| | | | - Laurent Misery
- Laboratory of Neurosciences of Brest, EA4685; Faculty of Medicine and Health Sciences; University of Brest; Brest France
- Department of Dermatology; Brest University Hospital; Brest France
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Siepmann D, Lotts T, Blome C, Braeutigam M, Phan NQ, Butterfass-Bahloul T, Augustin M, Luger TA, Ständer S. Evaluation of the antipruritic effects of topical pimecrolimus in non-atopic prurigo nodularis: results of a randomized, hydrocortisone-controlled, double-blind phase II trial. Dermatology 2013; 227:353-60. [PMID: 24281309 DOI: 10.1159/000355671] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 09/15/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In the treatment of atopic dermatitis, pimecrolimus has high antipruritic effects. OBJECTIVE To investigate the efficacy of 1% pimecrolimus cream in comparison to 1% hydrocortisone cream in non-atopic prurigo nodularis (PN). METHODS A randomized, controlled, double-blind study with intraindividual randomization was done in 30 patients (17 females, 13 males; mean age 58.5 years) with PN. RESULTS Pruritus intensity decreased significantly (p < 0.001) on both treated sides as early as after 10 days of treatment; scratch lesions improved (p < 0.001). Quality of life as assessed by the Dermatology Life Quality Index improved significantly. However, a significant advantage of pimecrolimus over hydrocortisone was not found. CONCLUSION The results suggest that the non-steroid pimecrolimus is an effective alternative for PN treatment.
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Affiliation(s)
- Dorothee Siepmann
- Competence Center Chronic Pruritus, Department of Dermatology, University Hospital of Münster, Münster, Germany
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Lebonvallet N, Pennec JP, Le Gall C, Pereira U, Boulais N, Cheret J, Jeanmaire C, Danoux L, Pauly G, Misery L. Effect of human skin explants on the neurite growth of the PC12 cell line. Exp Dermatol 2013; 22:224-5. [DOI: 10.1111/exd.12095] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2013] [Indexed: 12/27/2022]
Affiliation(s)
| | | | - Christelle Le Gall
- Laboratoire des Neurosciences de Brest, LNB, EA46855; Université de Bretagne Occidentale; Brest; France
| | - Ulysse Pereira
- Laboratoire des Neurosciences de Brest, LNB, EA46855; Université de Bretagne Occidentale; Brest; France
| | - Nicholas Boulais
- Laboratoire des Neurosciences de Brest, LNB, EA46855; Université de Bretagne Occidentale; Brest; France
| | - Jeremy Cheret
- Laboratoire des Neurosciences de Brest, LNB, EA46855; Université de Bretagne Occidentale; Brest; France
| | | | - Louis Danoux
- BASF Beauty Care Solutions France SAS; Pulnoy; France
| | - Gilles Pauly
- BASF Beauty Care Solutions France SAS; Pulnoy; France
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Klusch A, Ponce L, Gorzelanny C, Schäfer I, Schneider SW, Ringkamp M, Holloschi A, Schmelz M, Hafner M, Petersen M. Coculture model of sensory neurites and keratinocytes to investigate functional interaction: chemical stimulation and atomic force microscope-transmitted mechanical stimulation combined with live-cell imaging. J Invest Dermatol 2012; 133:1387-90. [PMID: 23235528 DOI: 10.1038/jid.2012.471] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Managing itch: Can we do better. World J Dermatol 2012; 1:3-5. [DOI: 10.5314/wjd.v1.i2.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Itch is a common problem and it can be debilitating. In the approach to managing chronic pruritic diseases, the key would be to identify the underlying cause and to adopt treatment specific to the condition. Unfortunately, in many cases, the cause/s can be occult. A careful examination for an underlying primary dermatosis is required, and repeated examinations at intervals may be needed. In generalized pruritus without a primary dermatosis, investigations to exclude a systemic disease are usually necessary. If the cause is still not determined, a trial of therapy may be very useful. The next step in the approach to chronic pruritus would be to use anti-pruritic agents specific to the type of pruritic disease. As we understand more about the patho-physiology of the various types of chronic pruritic diseases, we will be able to judiciously use treatment targeting the underlying mechanisms better and thereby achieve more favorable results. It is important to understand that itch is a sensation of multi-dimensional nature. In addition to its somatosensory aspect, it is closely linked to emotion and cognition. Very often, chronic pruritus originates from an organic disease but is amplified by the psychology of the patient. It is important to check if there are psycho-social issues that accompanies the presentation of chronic pruritus, and addressing them provides for a more effective and holistic management to the condition. A multi-disciplinary clinic would be suited to better address these aspects. Such a multi-disciplinary clinic would typically comprise a dermatologist, a nurse educator, a psychologist, a psychiatrist and medical social worker. In summary, our current clinical management of itch can be improved through careful identification of the underlying cause/s, using therapies specific for the disease and targeting the pathological mechanisms, and adopting a holistic approach to the clinical problem.
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Abstract
Scalp pruritus is a common complaint that is considered a diagnostically and therapeutically challenging situation. Scalp skin has a unique neural structure that contains densely innervated hair follicles and dermal vasculature. In spite of the recent advances in our understanding of itch pathophysiology, scalp itching has not been studied as yet. In this review, we summarize the current knowledge on the neurobiology of scalp and hair follicles as well as itch mediators and provide a putative mechanism for scalp itch with special emphasis on neuroanatomy and pathophysiology.
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Affiliation(s)
- Ghada A Bin Saif
- Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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67
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Abstract
Itch, or pruritus, is the predominant symptom associated with acute and chronic cutaneous disease, and in some cases may be debilitating. To date, there is no single universally effective anti-itch treatment. Because the pathophysiology of itch in most cutaneous or systemic disorders remains unclear, antipruritic therapy is often directed against a variety of targets, including the epidermal barrier, immune system, or the nervous system. Topical therapy is the mainstay of dermatologic management of acute or localized itch or in patients with contraindications to systemic therapies. This review will summarize current topical therapies to treat pruritus and discuss potential future therapies.
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Tey HL, Yosipovitch G. Targeted treatment of pruritus: a look into the future. THE BRITISH JOURNAL OF DERMATOLOGY 2011. [PMID: 21219293 DOI: 10.1111/j.1365-2133.2011.10217.x.] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Recent advances in pruritus research have elucidated mediators and neuronal pathways involved in itch transmission, and this fast emerging knowledge may possibly be translated into new therapies in the near future. In the skin and peripheral nerves, potential mediator and receptor therapeutic targets include the H4 histamine receptor, protease-activated receptor 2, serine proteases, cathepsin S, peripheral mu- and kappa-opioid receptors, interleukin-31, transient receptor potential vanilloid 1 and 3, fatty acid amide hydrolase, nerve growth factor and its receptor, acetylcholine, and the Mas-related G protein-coupled receptors. In the spinal cord, gastrin-related peptide and its receptor, as well as substance P and its receptor neurokinin receptor-1 serve as potential therapeutic targets. In the brain, reduction of itch perception and modulation of emotions may possibly be achieved through drugs acting on the anterior cingulate cortex. Clinically, management of pruritus should be instituted early and should address the skin pathology, peripheral neuropathy, central sensitization, and the cognito-affective aspects of the disease.
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Affiliation(s)
- H L Tey
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1071, USA
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Abstract
Recent advances in pruritus research have elucidated mediators and neuronal pathways involved in itch transmission, and this fast emerging knowledge may possibly be translated into new therapies in the near future. In the skin and peripheral nerves, potential mediator and receptor therapeutic targets include the H4 histamine receptor, protease-activated receptor 2, serine proteases, cathepsin S, peripheral mu- and kappa-opioid receptors, interleukin-31, transient receptor potential vanilloid 1 and 3, fatty acid amide hydrolase, nerve growth factor and its receptor, acetylcholine, and the Mas-related G protein-coupled receptors. In the spinal cord, gastrin-related peptide and its receptor, as well as substance P and its receptor neurokinin receptor-1 serve as potential therapeutic targets. In the brain, reduction of itch perception and modulation of emotions may possibly be achieved through drugs acting on the anterior cingulate cortex. Clinically, management of pruritus should be instituted early and should address the skin pathology, peripheral neuropathy, central sensitization, and the cognito-affective aspects of the disease.
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Affiliation(s)
- H L Tey
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1071, USA
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Zhang B, Alysandratos KD, Angelidou A, Asadi S, Sismanopoulos N, Delivanis DA, Weng Z, Miniati A, Vasiadi M, Katsarou-Katsari A, Miao B, Leeman SE, Kalogeromitros D, Theoharides TC. Human mast cell degranulation and preformed TNF secretion require mitochondrial translocation to exocytosis sites: relevance to atopic dermatitis. J Allergy Clin Immunol 2011; 127:1522-31.e8. [PMID: 21453958 DOI: 10.1016/j.jaci.2011.02.005] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Revised: 01/10/2011] [Accepted: 02/01/2011] [Indexed: 12/24/2022]
Abstract
BACKGROUND Mast cells derive from hematopoietic cell precursors and participate in tissue allergic, immune, and inflammatory processes. They secrete many mediators, including preformed TNF, in response to allergic, neuropeptide, and environmental triggers. However, regulation of mast cell degranulation is not well understood. OBJECTIVE We investigated the role of mitochondrial dynamics in degranulation of human cultured mast cells. METHODS Human umbilical cord blood-derived mast cells (hCBMCs) and Laboratory of Allergic Diseases 2 (LAD2) mast cells were examined by confocal and differential interference contrast microscopy during activation by IgE/antigen and substance P (SP). Mast cells in control and atopic dermatitis (AD) skin were evaluated by transmission electron microscopy. LAD2 cells were pretreated with mitochondrial division inhibitor, a dynamin-related protein 1 (Drp1) inhibitor, and small interfering RNA for Drp1, which is necessary for mitochondrial fission and translocation. Calcineurin and Drp1 gene expression was analyzed in stimulated LAD2 cells and AD skin biopsies. RESULTS Stimulation of hCBMCs with IgE/antigen or LAD2 cells with SP leads to rapid (30 minutes) secretion of preformed TNF. Degranulation is accompanied by mitochondrial translocation from a perinuclear location to exocytosis sites. Extracellular calcium depletion prevents these effects, indicating calcium requirement. The calcium-dependent calcineurin and Drp1 are activated 30 minutes after SP stimulation. Reduction of Drp1 activity by mitochondrial division inhibitor and decrease of Drp1 expression using small interfering RNA inhibit mitochondrial translocation, degranulation, and TNF secretion. Mitochondrial translocation is also evident by transmission electron microscopy in skin mast cells from AD biopsies, in which gene expression of calcineurin, Drp1, and SP is higher than in normal skin. CONCLUSION Human mast cell degranulation requires mitochondrial dynamics, also implicated in AD.
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Affiliation(s)
- Bodi Zhang
- Molecular Immunopharmacology and Drug Discovery Laboratory, Department of Molecular Physiology and Pharmacology, Tufts University School of Medicine, Boston, MA 02111, USA
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Rouxel AM, Le Toux G, Misery L. Tacrolimus en bains de bouche dans le traitement de seconde intention du lichen plan buccal érosif. Ann Dermatol Venereol 2010; 137:648-9. [DOI: 10.1016/j.annder.2010.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Revised: 05/28/2010] [Accepted: 06/22/2010] [Indexed: 10/19/2022]
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Abstract
IMPORTANCE OF THE FIELD Pruritus is the predominant symptom of skin disease. Owing to the poorly understood pathophysiology, the development of effective treatment modalities for pruritus has proven to be particularly difficult. At present, there is no universally accepted therapy for itch. The purpose of this review is to provide an update on the treatment of pruritus. AREAS COVERED IN THIS REVIEW An overview of current, emerging and possible future therapies for pruritus is provided. WHAT THE READER WILL GAIN Insights into possible treatment regimes for pruritus in different clinical scenarios. TAKE HOME MESSAGE The therapy of pruritus is challenging and at present takes on an individualistic approach. Recent advancements in the mechanisms that underlie this distressing symptom have identified new targets for future therapy.
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Affiliation(s)
- Tejesh Patel
- Division of Dermatology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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