Hercogová Jana
Department of Dermatovenereology, 2nd Medical School, Charles University, Prague, Czech Republic.
Dermatol Ther. 2005 Jul-Aug;18(4):341-3. doi: 10.1111/j.1529-8019.2005.00033.x.
Topical anti-itch therapy could be causative (antiviral, antimycotic, and/or antiparasitic preparations) or symptomatic. Symptomatic therapy includes substituting some other sensation by cooling, heating, and/or counterirritation, by anesthesia of sensory nerve endings with local anesthetics, blocking mediators of pruritus (to deplete substance P or to block acetylcholine release), and reducing inflammation of the skin with corticosteroids or topical immunomodulators (pimecrolimus and tacrolimus). In addition to drugs, the patient should be taught to use emollients and to avoid skin dryness and vasodilatation by contact with irritants. Topical anti-itch preparations can be recommended not only for treatment of localized pruritus, but also for therapy of generalized pruritus when general measures are not effective, systemic drugs are contraindicated, and/or as addition to causative or systemic therapy. Topical anti-itch preparations should be prescribed after the diagnosis is made and used as the first-choice treatment together with general measures.
局部止痒疗法可能是病因性的（抗病毒、抗真菌和/或抗寄生虫制剂）或对症性的。对症治疗包括通过冷却、加热和/或反刺激来替代其他感觉，通过局部麻醉剂麻醉感觉神经末梢，阻断瘙痒介质（消耗P物质或阻断乙酰胆碱释放），以及用皮质类固醇或局部免疫调节剂（吡美莫司和他克莫司）减轻皮肤炎症。除了药物治疗外，还应教导患者使用润肤剂，并避免因接触刺激物而导致皮肤干燥和血管扩张。局部止痒制剂不仅可推荐用于治疗局限性瘙痒，当一般措施无效、全身用药禁忌时，也可用于治疗全身性瘙痒，和/或作为病因性或全身治疗的辅助用药。局部止痒制剂应在做出诊断后开出处方，并与一般措施一起作为首选治疗方法使用。
