What Do We Know about Pruritus in Very Young Infants? A Literature Review

Round 1

Reviewer 1 Report

I have read the paper with great interest.

Although it reminds us that itch is indeed present in infants, it would be nice to see the authors' suggestion on the possible methods of itch evaluation in this population.

Since infants's sleeping hours are long it would be interesting to know if this sleep (mostly physiologic and necessary) affects their sense of itch/pain.

Infants before the age of 6 months definitely are not able to scratch themselves. This would break the itch-scratch vicious cycle which may lessen the degree of itch that the older population feel. Any comment on this is appreciated.

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Reviewer 2 Report

The manuscript is focused n a very important subject i.e. pruritus in young infants. We know that itching is much more bothersome than pain. representatives of Homo sapiens who know how to scratch to get rid of itching, in contrast to young infants who does not, can easily manifest this bothersome feeling to the third parties.

The Authors did a very good work and make us aware that there is not much known about such terrible symptom as itch is in young infants and there is a lot of work to do. 

The manuscript is elegantly written based on extensive literature review. To me the manuscript deserves to be published in the present form in Cells.

Author Response

            Thank you for your interest in our review.

Reviewer 3 Report

An interesting narrative review focusing on the relationship between itch and young infants, also describing its relationship with the most common dermatological conditions causing pruritus at a young age, such as atopic dermatitis; I found the article very informative and eligible for publication after some revisions:

I would probably add a small paragraph focusing on possible treatments of itch at young age and their mechanism of action.

line 235 you should add: "Atopic Dermatitis is a common inflammatory skin disease characterized by skin and systemic inflammation and barrier dysfunction. The clinical presentation varies depending
on age, ethnicity, and the underlying biologic mechanisms " and cite an article such as doi: 10.1111/exd.14276. and doi: 10.18176/jiaci.0519.

line 275 you should add that is very difficult to measure the impact of pruritus in child under 1y.o. due to the absence of precise measures.

Thank You

Author Response

Thank you for your interest in this review and for your comments.

1. “I would probably add a small paragraph focusing on possible treatments of itch at young age and their mechanism of action.”

Thank you for your comments. As our aim was to specifically review the existing evidence on abilities of young infants to experience itch and on how to assess itch-related discomfort in this population, we decided to focus only on itch diagnosis and not to deal with the question of itch treatments which could be the subject of a further review.

2. “line 235 you should add: "Atopic Dermatitis is a common inflammatory skin disease characterized by skin and systemic inflammation and barrier dysfunction. The clinical presentation varies depending on age, ethnicity, and the underlying biologic mechanisms " and cite an article such as doi: 10.1111/exd.14276. and doi: 10.18176/jiaci.0519.”

Thank you for your comment and references. We made the required revisions (cf lines 234-237).

3. “line 275 you should add that is very difficult to measure the impact of pruritus in child under 1y.o. due to the absence of precise measures.”

Thank you for your comment. We made the revisions accordingly (cf line 274).

Reviewer 4 Report

Thank you for your comprehensive review on the topic of pruritus in young infants.

There are a few typographical errors in the references section. The most notable are the following:

1. Reference 5: “473-478” instead of “473-473”.
2. Reference 7: “Obstet. Gynecol. 1999…” instead of “Obstet. 1999…”
3. Reference 12: “Adv. Wound Care 2014…” instead of “Adv. Wound Care 2013…”
4. Reference 17: “Dev. Biol.” instead of “Dev.l Biol.”
5. Reference 30: “Anand, K.J.; Hickey, P.R.” the authors’ names.
6. Reference 37: The year of publication is 2012 and the DOI “10.2340/00015555-1342”.
7. Reference 41: “Carroll, C.L.; Balkrishnan, R.; Feldman S.R.; Fleischer, A.B. Jr; Manuel, J.C.” instead of “Carroll, C.L.; Fleischer, A.B.; Balkrishnan, R.; Feldman S.R.; Manuel, J.C.”
8. Reference 46: “Chamlin, S.L.; Frieden, I.J.; Williams, M.L.; Chren, M-M.” the authors’ list.
9. Reference 49: “Pediatr. Dermatol. 2021, 38, 591-601” and “Kong, H.E.; Francois, S.; Smith, S.; Spraker, M.; Lawley, L.P.; Lee, G.; Chen, K-H.; Roberts, J.S.; Chen, S.C.”, the third and seventh authors’ names.

Author Response

Thank you for your interest in our review. Revisions in the references section have been made.