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Dermatologic Clinics

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https://www.readbyqxmd.com/read/29929606/erratum
#1
(no author information available yet)
No abstract text is available yet for this article.
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29929605/drugs-on-the-horizon-for-chronic-pruritus
#2
REVIEW
Matthew W McEwen, Elizabeth M Fite, Gil Yosipovitch, Tejesh Patel
Chronic pruritus is a common condition that has a detrimental impact on quality of life. As the molecular pathogenesis of itch is elucidated, novel therapies that disrupt itch pathways are being investigated. Emerging treatments include drugs targeting the neural system, drugs targeting the immune system, antihistamines, bile acid transport inhibitors, and topical drugs that work through a variety of mechanisms such as phosphodiesterase-4 inhibition or targeting of nerve ion channels. Many of these therapies show promising results in the treatment of chronic itch of various etiologies, such as atopic dermatitis, psoriasis, uremic pruritus, and cholestatic pruritus...
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29929604/immunomodulating-agents-as-antipruritics
#3
REVIEW
Stephen Erickson, Zachary Nahmias, Ilana S Rosman, Brian S Kim
Chronic pruritus, or itch lasting greater than 6 weeks, is an increasingly common and debilitating medical problem. Recent studies have unveiled previously unrecognized neuroimmune axes whereby inflammatory cytokines act directly on the nervous system to promote itch. Thus, the emergence of newer targeted biologic therapies has generated the possibility of novel treatment strategies for chronic itch disorders. This article reviews the pathophysiology of multiple chronic itch disorders, including atopic dermatitis, chronic idiopathic pruritus, chronic urticaria, and prurigo nodularis...
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29929603/pruritus-associated-with-targeted-anticancer-therapies-and-their-management
#4
REVIEW
Jennifer Wu, Mario E Lacouture
Targeted anticancer therapies have significantly increased the survival of patients with a variety of malignancies, improving tolerability and treatment duration. The increased lifespan and the expanded use of targeted agents have led to a variety of treatment-related adverse events. Pruritus, a common dermatologic adverse event with various incidences ranging from 2.2% to 47% across different categories of targeted anticancer therapies, has been overlooked. This article reviews the incidence, accompanying skin conditions, possible pathomechanism, and proposed management algorithms of pruritus associated with targeted therapies, including immunotherapies...
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29929602/psychogenic-pruritus-and-its-management
#5
REVIEW
Anna Buteau, Jason Reichenberg
Chronic itching can be frustrating for patients and providers, and patients are not always willing to accept that their psychiatric health has an impact on their skin. Psychogenic pruritus is defined as itch not related to dermatologic or systemic causes. When a patient presents with pruritus, regardless of the presumed cause, the standard work-up should include a thorough history, dermatologic examination, and laboratory examinations or biopsies as needed. If no medical source is found, the provider must work in partnership with the patient to explore other causes and that may include acknowledging and treating underlying psychiatric conditions...
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29929601/scabies-itch
#6
REVIEW
Arnaud Jannic, Charlotte Bernigaud, Emilie Brenaut, Olivier Chosidow
Itch is the cardinal symptom of scabies, present in more than 90% of the cases, generalized and intense, worsening at night, and often sparing the head. The primary complications of the itch in scabies are secondary bacterial infections and psychosocial issues leading to impairment on life quality. Currently, there are no specific data analyzing mechanisms of the itch in scabies, but the latest progress made in the understanding of host-mite interactions may help to improve understanding. Management of itch in scabies consists primarily of the treatment of the mite infestation, but sometimes the itching sensation may persist after adequate therapy...
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29929600/management-of-chronic-hepatic-itch
#7
REVIEW
Miriam M Düll, Andreas E Kremer
Hepatic itch remains among the most agonizing symptoms for affected patients and a major clinical challenge for physicians. Pruritus may occur in almost all liver diseases, particularly those with cholestatic features. Hepatic itch arises irrespective of the severity of the underlying liver disease or extent of cholestasis. Antihistamines are ineffective in hepatic itch. Therapeutic recommendations consist of a guideline-based stepwise approach, starting with the anion exchange resin cholestyramine, followed by rifampicin, naltrexone, and sertraline...
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29929599/end-stage-renal-disease-chronic-itch-and-its-management
#8
REVIEW
Radomir Reszke, Jacek C Szepietowski
End-stage renal disease chronic itch is a frequent symptom that bothers patients with advanced stages of chronic kidney disease. The pathogenesis of the chronic itch symptom is complex and not yet fully understood and includes many metabolic, immunologic, and neurogenic factors. A significant burden of the disease results in decreased quality of life with sleep impairment, depressive symptoms, and increased mortality of affected individuals. No treatment of choice is available; topical therapy (emollients), phototherapy (UV-B), and systemic therapy (antiepileptics, opioid agonists, and antagonists) provide significant relief in varying percentages of patients...
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29929598/pruritus-in-autoimmune-connective-tissue-diseases
#9
REVIEW
Gideon P Smith, Yahya Argobi
Pruritus in autoimmune connective tissue diseases is a common symptom that can be severe and affect the quality of life of patients. It can be related to disease activity and severity or occur independent of the disease. Appropriate therapy to control the itch depends on the etiology, and it is therefore essential to first work-up these patients for the underlying trigger.
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29929597/pruritus-in-pregnancy-and-its-management
#10
REVIEW
Mark A Bechtel
Pruritus in pregnancy can be a source of significant discomfort in the pregnant patient. Some cases are associated with pregnancy-specific dermatoses, although some patients experience a flare of a preexisting dermatosis. Severe pruritus may be a manifestation of a pregnancy-specific dermatosis associated with increased fetal risks and complications. Early accurate diagnosis and appropriate management are important. Examination often reveals important clinical findings, aiding accurate diagnosis. Pemphigoid gestationis often presents with periumbilical involvement, whereas polymorphic eruption of pregnancy spares the umbilicus and presents in the striae distensae...
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29929596/pruritus-in-cutaneous-t-cell-lymphoma-and-its-management
#11
REVIEW
Linda Serrano, Maria Estela Martinez-Escala, Xiaolong A Zhou, Joan Guitart
Pruritus is a common symptom in cutaneous T-cell lymphoma (CTCL) and critically affects the quality of life of patients. Understanding the pruritogenesis has led to development of new therapeutic agents with promising outcomes in management of this recalcitrant symptom. Clinical assessments are warranted to aid in evaluation of treatment response or disease recurrence. Severe pruritus scores may require further investigation of emotional distress for a better patient approach. Dermatologists play a key role in the treatment of CTCL-pruritus by guiding the patient in the importance of preserving the integrity of the skin barrier...
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29929595/female-genital-itch
#12
REVIEW
Jessica A Savas, Rita O Pichardo
Vulvar pruritus is a common complaint among young girls and women presenting to primary care physicians, gynecologists, and dermatologists. Female genital itch is especially disruptive because of its interference with sexual function and intimacy. Causes of vulvar itch are vast and may be inflammatory, environmental, neoplastic, or infectious, often with several causes coexisting simultaneously. Diagnosis may be difficult because of the unique anatomy and inherent properties of genital and perianal skin. Treatment is aimed at eliminating outside irritants, restoring epidermal barrier function, and suppressing inflammation...
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29929594/diagnosis-and-management-of-neuropathic-itch
#13
REVIEW
Jordan Daniel Rosen, Anna Chiara Fostini, Gil Yosipovitch
Neuropathic pruritus is a challenging condition that can be caused by injury or dysfunction in any part of the nervous system. A vast array of clinical pictures exist, including both localized and generalized pruritus, and their principal entities are described in this article. Diagnosis is often difficult and depends on patient history, imaging, and neurophysiologic studies. Other causes of chronic itch should be excluded. The management of neuropathic itch is demanding and the majority of interventions are not curative...
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29929593/chronic-pruritus-in-the-geriatric-population
#14
REVIEW
Taige Cao, Hong Liang Tey, Gil Yosipovitch
Chronic pruritus (>6 week's duration) in the geriatric population (≥65 years old), is an increasing health care problem. The pathophysiologic predisposing factors are abnormalities of the epidermal barrier, immune system, and nervous system. Causes can be dichotomized into histaminergic and nonhistaminergic pruritus. Topical treatments are generally safe. Systemic treatments are chosen depending on the condition, comorbid diseases, and drug interactions. Treatment options are limited. Progress has been made in identifying itch-selective mediators over the last decade...
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29929592/prurigo-nodularis-and-its-management
#15
REVIEW
Claudia Zeidler, Gil Yosipovitch, Sonja Ständer
Prurigo nodularis occurs with chronic pruritus and the presence of single to multiple symmetrically distributed, hyperkeratotic, and intensively itching nodules. Diverse dermatologic, systemic, neurologic, or psychiatric conditions can lead to prurigo nodularis. Structural analysis demonstrated a reduced intraepidermal nerve fiber density and increased dermal levels of nerve growth factor and neuropeptides such as substance P and calcitonin gene-related peptide. Novel therapy concepts such as inhibitors at neurokinin-1, opioid receptors, and interleukin-31 receptors have been developed...
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29929591/diagnostic-work-up-of-the-itchy-patient
#16
REVIEW
Sarina B Elmariah
Pruritus is a common and troubling symptom associated with many dermatologic, systemic, neurologic, or psychiatric disorders. This article reviews the current understanding of the pathogenesis of itch and offers a differential diagnosis for the causes of chronic pruritus. The article discusses key diagnostic steps and considerations when evaluating patients with chronic pruritus.
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29929590/pathophysiology-of-itch
#17
REVIEW
Ethan A Lerner
Chronic itch is a clinically challenging yet scientifically remarkable and complex process. Increasing understanding of the pathophysiology of chronic itch is leading to targeted therapeutic approaches that are now dramatically improving quality of life. This improvement will accelerate as the tools of basic and clinical research continue to be applied to this previously intractable problem.
July 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29499806/complexities-of-rosacea
#18
EDITORIAL
Steven R Feldman, Leah A Cardwell, Sarah L Taylor
No abstract text is available yet for this article.
April 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29499805/measurement-of-disease-severity-in-a-population-of-rosacea-patients
#19
REVIEW
Hossein Alinia, Sara Moradi Tuchayi, Sara M James, Leah A Cardwell, Sonali Nanda, Naeim Bahrami, Olabola Awosika, Irma Richardson, Karen E Huang, Steven R Feldman
Severity of rosacea in populations is not well characterized. A validated self-assessment tool was used to study the relationship between rosacea severity and demographic factors. Subjects were adult patients with a clinical diagnosis of rosacea. Self-assessment severity scores were significantly higher in participants less than 60 years old (mean 3.43 ± 1.07) compared with those greater than or equal to 60 years old (mean 3.09 ± 1.13; P = .04). Self-assessment severity scores were significantly higher in men (3...
April 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29499804/validity-and-reliability-of-a-rosacea-self-assessment-tool
#20
REVIEW
Sara Moradi Tuchayi, Hossein Alinia, Lucy Lan, Olabola Awosika, Abigail Cline, Leah A Cardwell, Dennis Hopkinson, Irma Richardson, Karen E Huang, Steven R Feldman
The lack of validated rosacea assessment tools is a hurdle in assessing rosacea severity. This article discusses a valid and reliable rosacea severity self-assessment tool (RSAT) to measure rosacea severity. To determine test-retest validity, participants completed the self-assessment twice. A blinded physician graded the participant's disease severity with the Investigator Global Severity (IGS) score. Pearson correlations were used to assess the relationship between the self-assessment measure and the IGS...
April 2018: Dermatologic Clinics
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