Department of Dermatology, University of Rochester School of Medicine, Rochester, New York 14642, USA.
J Am Acad Dermatol. 2012 Oct;67(4):760-8. doi: 10.1016/j.jaad.2011.12.021. Epub 2012 Jan 30.
Pruritus can be a distressing and even debilitating symptom for patients with cutaneous T-cell lymphoma (CTCL). To date, few studies have evaluated the pathophysiology of this symptom. Because of this, therapy for pruritus in CTCL has mainly relied on those therapies that target and treat the lymphoma. For patients living with CTCL that relapses or becomes refractory to treatment, and who continue to experience severe itch, this lymphoma-targeted treatment may not be enough to combat their pruritus. Therefore, other itch-targeted therapies are needed for use in this disease.
We sought to evaluate the current evidence regarding the mechanism of action and treatments for pruritus associated with CTCL.
An explicit and thorough search was restricted to all peer-reviewed literature available through MEDLINE (1950 to September 2011) and PubMed. Search terms used were "pruritus," "cutaneous T-cell lymphoma," "CTCL," "mycosis fungoides," "MF," and "Sézary syndrome." All studies that involved pruritus in CTCL, mycosis fungoides, or Sézary syndrome were evaluated by all 3 authors.
The current literature helps to identify therapies and possible mechanisms for treating patients with CTCL-associated pruritus.
Most studies were preclinical. Only studies involving mechanisms of action or treatment were included.
A guideline is necessary to assist in the treatment of pruritus in CTCL and additional studies are necessary to uncover the exact mechanism or mechanisms of action.
瘙痒可能是皮肤 T 细胞淋巴瘤(CTCL)患者的一种痛苦甚至使人虚弱的症状。迄今为止,很少有研究评估这种症状的病理生理学。由于这个原因,CTCL 瘙痒的治疗主要依赖于那些针对和治疗淋巴瘤的疗法。对于患有复发或对治疗产生抗药性且持续出现严重瘙痒的 CTCL 患者,这种针对淋巴瘤的治疗可能不足以缓解其瘙痒。因此,需要在这种疾病中使用其他瘙痒靶向治疗。
我们旨在评估与 CTCL 相关的瘙痒的作用机制和治疗的现有证据。
通过 MEDLINE(1950 年至 2011 年 9 月)和 PubMed 对所有同行评议文献进行明确而全面的搜索。使用的搜索词是“瘙痒”、“皮肤 T 细胞淋巴瘤”、“CTCL”、“蕈样真菌病”、“MF”和“Sézary 综合征”。所有由 3 位作者评估的涉及 CTCL、蕈样真菌病或 Sézary 综合征瘙痒的研究。
当前文献有助于确定治疗 CTCL 相关瘙痒的疗法和可能的机制。
大多数研究都是临床前的。仅纳入了涉及作用机制或治疗的研究。
有必要制定指南来协助 CTCL 瘙痒的治疗,并且需要进一步研究以揭示确切的作用机制。