Kaşıntı
Özet
Kaşıntı, dermatolojik hastalıkların yanı sıra sistemik, nörolojik ve psikiyatrik bozukluklarla da ilişkilendirilen, yaygın ve yaşam kalitesini olumsuz etkileyen çok boyutlu bir semptomdur. Tanı süreci, birincil deri lezyonlarının varlığına göre şekillenerek laboratuvar testleri ve ayrıntılı bir fizik muayene ile desteklenen bütüncül bir yaklaşımı zorunlu kılar. Tedavi stratejileri ise altta yatan nedene göre belirlenmekte; topikal ajanlar, sistemik ilaçlar ve fototerapi gibi fiziksel yöntemler ile psikoterapötik yaklaşımları içermektedir.
Itching is a multidimensional and common symptom that is associated with systemic, neurological, and psychiatric disorders as well as dermatological diseases, significantly impacting the quality of life. The diagnostic process necessitates a holistic approach supported by laboratory tests and detailed physical examination, shaped by the presence or absence of primary skin lesions. Treatment strategies are determined based on the underlying cause, encompassing topical agents, systemic medications, physical methods like phototherapy, and psychotherapeutic approaches.
Referanslar
Leader B, Carr CW, Chen SC. Pruritus epidemiology and quality of life. Handb Exp Pharmacol. 2015;226:15-38
Savin JA. How should we define itching?. J Am Acad Dermatol. 1998;39(2 Pt 1):268-269. doi:10.1016/s0190-9622(98)70087-8
Zucker I, Yosipovitch G, David M, Gafter U, Boner G. Prevalence and characterization of uremic pruritus in patients undergoing hemodialysis: uremic pruritus is still a major problem for patients with end-stage renal disease. J Am Acad Dermatol. 2003;49(5):842-846. doi:10.1016/s0190-9622(03)02478-2
Weishaar E, Florence D. Epidemiology. In: Misery L, Stander S. Pruritus e-book. London: Springer-Verlag; 2016.p.73-9.
Schmelz M, Schmidt R, Bickel A, Handwerker HO, Torebjörk HE. Specific C-receptors for itch in human skin. J Neurosci. 1997;17(20):8003-8008. doi:10.1523/JNEUROSCI.17-20-08003.1997
Reddy VB, Iuga AO, Shimada SG, LaMotte RH, Lerner EA. Cowhage-evoked itch is mediated by a novel cysteine protease: a ligand of protease-activated receptors. J Neurosci. 2008;28(17):4331-4335. doi:10.1523/JNEUROSCI.0716-08.2008
Sun YG, Zhao ZQ, Meng XL, Yin J, Liu XY, Chen ZF. Cellular basis of itch sensation. Science. 2009;325(5947):1531-1534. doi:10.1126/science.1174868
Davidson S, Giesler GJ. The multiple pathways for itch and their interactions with pain. Trends Neurosci. 2010;33(12):550-558. doi:10.1016/j.tins.2010.09.002
Namer B, Carr R, Johanek LM, Schmelz M, Handwerker HO, Ringkamp M. Separate peripheral pathways for pruritus in man. J Neurophysiol. 2008;100(4):2062-2069. doi:10.1152/jn.90482.2008
Davidson S, Zhang X, Yoon CH, Khasabov SG, Simone DA, Giesler GJ Jr. The itch-producing agents histamine and cowhage activate separate populations of primate spinothalamic tract neurons. J Neurosci. 2007;27(37):10007-10014. doi:10.1523/JNEUROSCI.2862-07.2007
White-Chu EF, Reddy M. Dry skin in the elderly: complexities of a common problem. Clin Dermatol. 2011;29(1):37-42. doi:10.1016/j.clindermatol.2010.07.005
Millikan LE. Treating pruritus. What's new in safe relief of symptoms?. Postgrad Med. 1996;99(1):173-184.
Mollanazar NK, Smith PK, Yosipovitch G. Mediators of Chronic Pruritus in Atopic Dermatitis: Getting the Itch Out?. Clin Rev Allergy Immunol. 2016;51(3):263-292. doi:10.1007/s12016-015-8488-5
Krueger G, Koo J, Lebwohl M, Menter A, Stern RS, Rolstad T. The impact of psoriasis on quality of life: results of a 1998 National Psoriasis Foundation patient-membership survey. Arch Dermatol. 2001;137(3):280-284.
Chosidow O. Clinical practices. Scabies. N Engl J Med. 2006;354(16):1718-1727. doi:10.1056/NEJMcp052784
Van Loey NE, Bremer M, Faber AW, Middelkoop E, Nieuwenhuis MK. Itching following burns: epidemiology and predictors. Br J Dermatol. 2008;158(1):95-100. doi:10.1111/j.1365-2133.2007.08278.x
Hu X, Sang Y, Yang M, Chen X, Tang W. Prevalence of chronic kidney disease-associated pruritus among adult dialysis patients: A meta-analysis of cross-sectional studies. Medicine (Baltimore). 2018;97(21):e10633. doi:10.1097/MD.0000000000010633)
Ponticelli C, Bencini PL. Pruritus in dialysis patients: a neglected problem. Nephrol Dial Transplant. 1995;10(12):2174-2176. doi:10.1093/ndt/10.12.2174
Ståhle-Bäckdahl M. Uremic pruritus. Clinical and experimental studies. Acta Derm Venereol Suppl (Stockh). 1989;145:1-38
Mettang T, Fritz P, Weber J, Machleidt C, Hübel E, Kuhlmann U. Uremic pruritus in patients on hemodialysis or continuous ambulatory peritoneal dialysis (CAPD). The role of plasma histamine and skin mast cells. Clin Nephrol. 1990;34(3):136-141.
Gilchrest BA, Stern RS, Steinman TI, Brown RS, Arndt KA, Anderson WW. Clinical features of pruritus among patients undergoing maintenance hemodialysis. Arch Dermatol. 1982;118(3):154-156.)))
Wang H, Yosipovitch G. New insights into the pathophysiology and treatment of chronic itch in patients with end-stage renal disease, chronic liver disease, and lymphoma. Int J Dermatol. 2010;49(1):1-11. doi:10.1111/j.1365-4632.2009.04249.x
Etter L, Myers SA. Pruritus in systemic disease: mechanisms and management. Dermatol Clin. 2002;20(3):459-vii. doi:10.1016/s0733-8635(02)00011-6
Scribner M. Diabetes and pruritus of the scalp. JAMA. 1977;237(15):1559.
Yamaoka H, Sasaki H, Yamasaki H, et al. Truncal pruritus of unknown origin may be a symptom of diabetic polyneuropathy. Diabetes Care. 2010;33(1):150-155. doi:10.2337/dc09-0632
Yosipovitch G. Chronic pruritus: a paraneoplastic sign. Dermatol Ther. 2010;23(6):590-596. doi:10.1111/j.1529-8019.2010.01366.x
Rowe B, Yosipovitch G. Malignancy-associated pruritus. Eur J Pain. 2016;20(1):19-23. doi:10.1002/ejp.760
Shirani Z, Kucenic MJ, Carroll CL, et al. Pruritus in adult dermatomyositis. Clin Exp Dermatol. 2004;29(3):273-276. doi:10.1111/j.1365-2230.2004.01510.x
Razykov I, Thombs BD, Hudson M, Bassel M, Baron M; Canadian Scleroderma Research Group. Prevalence and clinical correlates of pruritus in patients with systemic sclerosis. Arthritis Rheum. 2009;61(12):1765-1770. doi:10.1002/art.25010
Amaro P, Nunes A, Maçôas F, Ministro P, Baranda J, Cipriano A, et al. Ticlopidine-induced prolonged cholestasis: a case report. Eur J Gastroenterol Hepatol 1999;11:673–6.
Hunt CM, Washington K. Tetracycline-induced bile duct paucity and prolonged cholestasis. Gastroenterology 1994;107:1844–7.
Mikhail NE. Methimazole-induced cholestatic jaundice. South Med J 2004;97:178–82.
Nammour FE, Fayad NF, Peikin SR. Metformin-induced cholestatic hepatitis. Endocr Pract 2003; 9: 307–9.)))
Ständer S, Streit M, Darsow U, Niemeier V, Vogelgsang M, Ständer H et al. Diagnostisches undtherapeutisches Vorgehen bei chronischem Pruritus. J Dtsch Dermatol Ges 2006;4:350–70.
Shirin H, Schapiro JM, Arber N, Pinkhas J, Sidi Y, Salomon F. Erythromycin base-induced rash and liver function disturbances. Ann Pharmacother 1992;26:1522–3.
Orme S, da Costa D. Generalized pruritus associated with amlodipine. Br Med J 1997; 315: 463.
Odeh M, Oliven A. Verapamil-associated liver injury. Harefuah 1998;134:36–7.
Kowdley KV, Keeffe EB, Fawaz KA. Prolonged cholestasis due to trimethoprim sulfamethoxazole. Gastroenterology 1992;102:2148–50.
Larrey D, Amouyal G, Pessayre D, Degott C, Danne O, Machayekhi JP. Amitriptyline-induced prolonged cholestasis. Gastroenterology 1988;94:200–3.
Lane JE, McKenzie JT, Spiegel J. Brachioradial pruritus: a case report and review of the literature. Cutis. 2008;81(1):37-40.
Bernhard JD, Bordeaux JS. Medical pearl: the ice-pack sign in brachioradial pruritus. J Am Acad Dermatol. 2005;52(6):1073. doi:10.1016/j.jaad.2005.02.056
Mirzoyev SA, Davis MD. Brachioradial pruritus: Mayo Clinic experience over the past decade. Br J Dermatol. 2013;169(5):1007-1015. doi:10.1111/bjd.12483)
Koeppel MC, Bramont C, Ceccaldi M, Habib M, Sayag J. Paroxysmal pruritus and multiple sclerosis. Br J Dermatol. 1993;129(5):597-598. doi:10.1111/j.1365-2133.1993.tb00492.x
Lee HG, Stull C, Yosipovitch G. Psychiatric disorders and pruritus. Clin Dermatol. 2017;35(3):273-280. doi:10.1016/j.clindermatol.2017.01.008
Greco PJ, Ende J. Pruritus: a practical approach. J Gen Intern Med. 1992;7(3):340-349. doi:10.1007/BF02598094
Reich A, Szepietowski JC. Diagnostic Procedures of Itch. Curr Probl Dermatol. 2016;50:24-8.
Yosipovitch G, Bernhard JD. Clinical practice. Chronic pruritus. N Engl J Med. 2013;368(17):1625-1634. doi:10.1056/NEJMcp1208814
Aydıngöz İE. Sistemik pruritus sağaltımı. Şavk E, editör. Pruritus 1. Baskı. Ankara: türkiye klinikleri; 2019. P.78-84)
Elmariah SB, Lerner EA. Topical therapies for pruritus. Semin Kutan Med Surg. 2011;30 (2): 118-26.
Avcı C, Akarsu S. Fiziksel pruritus sağaltımı. Şavk E, editör. Pruritus. 1. Baskı. Ankara: Türkiye Klinikleri; 2019. P.85-90.
Kıvanç Altunay İ, Özkue E. Pruritusa psikoterapötik yaklaşım. Şavk E, editör. Pruritus. 1. Baskı. Ankara: Türkiye Klinikleri; 2019. P.91-6.