Novel Agents for Intractable Itch

C. B. Lynde; J. N. Kraft, MD; C. W. Lynde, MD, FRCPC


Skin Therapy Letter. 2008;13(1):6-9. 

In This Article

Abstract and Introduction

There exists a multitude of medical conditions that cause intractable itch, or pruritus. The successful management of this symptom depends explicitly on establishing the underlying cause. Studies have shown that drugs not traditionally used in the treatment of cutaneous disorders, such as opiate receptor antagonists, antidepressants, and antiepileptics, can provide symptomatic relief of intractable itch. These novel antipruritic agents will be explored in this review.

Itch, or pruritus, refers to an unpleasant sensation in the skin that provokes scratching. Arguably, all humans experience an itch at some point in their lives. One-fifth of the population is thought to suffer from some form of itch at any given moment.[1] The intensity of pruritus ranges from mild to severe, and can have a significant psychosocial impact on patients, by interfering with their sleep and daily activities. Itch is one of the most common symptoms associated with cutaneous disorders that require treatment from dermatologists.

Its management presents a treatment challenge, as many therapies are often tried to no avail.

Causation can sometimes be easily established, such as a primary dermatological disease (e.g., atopic dermatitis, psoriasis, urticaria), underlying renal or hepatic disease, or a drug-induced reaction (e.g., opiates). However, in many cases resolution of the symptom does not follow even after the etiology has been established; this is especially true for chronic disorders.

Table 1 and Table 2 summarize dermatologic and systemic disorders that can cause intractable itch.


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