Böhme T, Heitkemper T, Mettang T, Phan N Q, Ständer S
Kompetenzzentrum Chronischer Pruritus (KCP), Klinik für Hautkrankheiten, Universitätsklinikum Münster, Von-Esmarch-Str. 58, 48149, Münster, Deutschland.
Hautarzt. 2014 Aug;65(8):714-20. doi: 10.1007/s00105-014-2756-9.
Nephrogenic pruritus (NP) is a well-known associated symptom in patients with chronic renal failure. The aim of the present study was to make a detailed dermatological analysis including distribution of excoriations and their correlation with pruritus characteristics.
Data on a total of 17 patients with NP (14 males, mean 65.4 ± SD 14.3 years) were subjected to retrospective analysis. Most of the patients developed NP after start of kidney disease; however, in 20 % of the patients, there was premonitory appearance of the symptom 18 months (median) earlier. A majority of patients reported neuropathic symptom qualities (burning, stinging). In 94.1 % of patients xerosis was present; in 58.8 %, prurigo nodularis. The latter group of patients had a longer duration of pruritus as well as up to 10 years longer duration of renal disease than those without prurigo.
Pruritus characteristics of NP show a wide variance without a clear profile that is useful for clinical diagnosis. NP can occur premonitorily, and, if of long duration and with coexistent metabolic diseases, can develop into prurigo.
肾源性瘙痒(NP)是慢性肾衰竭患者中一种众所周知的相关症状。本研究的目的是进行详细的皮肤病学分析,包括抓痕分布及其与瘙痒特征的相关性。
对总共17例NP患者(14例男性,平均年龄65.4±标准差14.3岁)的数据进行回顾性分析。大多数患者在肾病开始后出现NP;然而,20%的患者在症状出现前18个月(中位数)就有先兆。大多数患者报告有神经性症状(灼痛、刺痛)。94.1%的患者存在皮肤干燥;58.8%的患者有结节性痒疹。后一组患者的瘙痒持续时间以及肾病持续时间比没有结节性痒疹的患者长10年。
NP的瘙痒特征差异很大,没有明确的特征可用于临床诊断。NP可在先兆期出现,如果持续时间长且伴有代谢性疾病,可发展为结节性痒疹。