Search Results (3)

Chronic pruritus (CP), attention-deficit/hyperactivity disorder (ADHD), and skin picking disorder (SPD) are medical conditions that involve both somatic and psychosocial dimensions, posing unique challenges in clinical management. While CP and SPD are often observed together, the link between ADHD and these conditions is less recognized. This conceptual work describes three women who suffered from a complex interplay of CP, ADHD, and SPD treated at our specialized bi-disciplinary psychodermatological pruritus clinic. Based on our clinical observation and a narrative review of the literature, we assume a bidirectional, triangular relationship between CP, ADHD, and SPD. To support this assumption, we propose two hypotheses: (1) a neurodevelopmental hypothesis, emphasizing that an underlying neurodevelopmental disorder, in this case, ADHD, might present with symptoms like dysfunction of sensory processing, impulsivity, and attention deficits as shared features that reinforce CP and SPD, and (2) a neuroinflammatory hypothesis, suggesting that similar neuroinflammatory signatures promote the co-occurrence of CP, ADHD, and SPD. In addition, we provide specific suggestions derived from our clinical experience on how to manage patients with this complex combination of conditions. Elucidating the interplay between CP, ADHD, and SPD might help develop personalized treatment strategies and improve outcomes. Full article

Background: Black and geriatric patients were reported in small scale studies to have more intense chronic pruritus (CP). Studies comparing itch across geriatric racial groups are lacking. Objectives: To compare the prevalence of CP in Black and White inpatients ≥ 65 years old as well as the top primary diagnoses of these populations. Methods: We used data from the National Inpatient Sample from 2016–2019 to analyze CP prevalence and ICD10-CM to identify diseases. The top five primary diagnoses were calculated for a subpopulation with CP. Sample characteristics were described, and the data was pooled and analyzed using IBM SPSS^® Complex Sample modules. Results: Among hospitalized Black inpatients ≥ 65 years old, the prevalence of CP was 0.26% while in the White cohort it was 0.22%. The top five primary diagnoses in the Black population with itch were sepsis (4.2%); hypertensive heart and chronic kidney disease (CKD) with heart failure (HF) and stage 1–4 CKD, or unspecified CKD (4.1%); acute kidney failure (4.0%); hypertensive heart and CKD with HF with stage 5 CKD, or end-stage renal disease (2.1%); and hypertensive heart disease with HF (1.7%). The top five primary diagnoses in the White population were sepsis (4.25%); acute kidney failure (3.0%); hypertensive heart and CKD with HF and stage 1–4 CKD, or unspecified CKD (2.5%); cellulitis of left lower limb (1.9%); and unilateral primary osteoarthritis, right knee (1.9%). Conclusions: Geriatric hospitalized Black patients demonstrated a higher prevalence of chronic itch compared with the White cohort, which may be related to the higher prevalence of chronic kidney disease in different stages of severity in this population. Full article

Chronic itch is one of the most prominent clinical characteristics of diverse systematic diseases. It is a devastating sensation in pathological diseases. Despite its importance, there are no FDA-labelled drugs specifically geared toward chronic itch. The associated complex pathogenesis and diverse causes escalate chronic itch to being one of the top challenges in healthcare. Humanized antibodies against IL-13, IL-4, and IL-31 proved effective in treatment of itch-associated atopic dermatitis but remain to be validated in chronic itch. There are still no satisfactory anti-itch therapeutics available toward itch-related neuropeptides including GRP, BNP, SST, CGRP, and SP. The newly identified potential itch targets including OSM, NMB, glutamate, periostin, and Serpin E1 have opened new avenues for therapeutic development. Proof-of-principle studies have been successfully performed on antagonists against these proteins and their receptors in itch treatment in animal models. Their translational interventions in humans need to be evaluated. It is of great importance to summarize and compare the newly emerging knowledge on chronic itch and its pathways to promote the development of novel anti-itch therapeutics. The goal of this review is to analyze the different physiologies and pathophysiologies of itch mediators, whilst assessing their suitability as new targets and discussing future therapeutic development. Full article