Iannone Michela, Janowska Agata, Dini Valentina, Tonini Giulia, Oranges Teresa, Romanelli Marco
Department of Dermatology, University of Pisa, 56126 Pisa, Italy.
Department of Health Sciences, Anna Meyer Children's University Hospital, University of Florence, 50139 Florence, Italy.
Medicines (Basel). 2019 Nov 15;6(4):112. doi: 10.3390/medicines6040112.
The aims of this review are to analyze the current literature regarding the characteristics and pathophysiological mechanisms of itch in chronic wounds, to assess the impact on quality of life and delayed-healing, to focus on the best strategies of prevention and treatment, to highlight the importance of on-going research in order to fully understand the pathophysiology, and to improve the management of target therapies. A systematic literature review was performed using MEDLINE, PubMed, Embase, Scopus, ScienceDirect, and the Cochrane Library. We included a total of 11 articles written in English with relevant information on the pathophysiology of itch in chronic wounds and on management strategies. Itch in chronic wounds was found to be correlated with xerosis, larger wound areas, necrotic tissue and amount of exudate, peripheral tissue edema, sclerosis, granulation tissue, contact dermatitis, and bacterial burden, as well as with lower quality of life. Although there are several aspecific pharmacological and non-pharmacological approaches, there appears to be no validated prevention or management strategy for itch in chronic wounds. Further studies are needed to clarify the association and pathophysiology of itch in chronic wounds, to evaluate the safety and efficacy of topical treatments on perilesional skin to reduce itch, to characterize multidimensional sensations of itch in chronic wounds, to identify specific cytokine and chemokine expressions that are correlated to a tailored-based approach, and to develop practical guidelines.
本综述的目的是分析当前关于慢性伤口瘙痒的特征和病理生理机制的文献，评估其对生活质量和愈合延迟的影响，关注最佳的预防和治疗策略，强调持续研究以充分理解病理生理学的重要性，并改善靶向治疗的管理。使用MEDLINE、PubMed、Embase、Scopus、ScienceDirect和Cochrane图书馆进行了系统的文献综述。我们总共纳入了11篇用英文撰写的文章，这些文章包含了关于慢性伤口瘙痒的病理生理学和管理策略的相关信息。发现慢性伤口瘙痒与皮肤干燥、较大的伤口面积、坏死组织、渗出液量、外周组织水肿、硬化、肉芽组织、接触性皮炎、细菌负荷以及较低的生活质量相关。尽管有几种非特异性的药物和非药物方法，但对于慢性伤口瘙痒似乎没有经过验证的预防或管理策略。需要进一步的研究来阐明慢性伤口瘙痒的关联和病理生理学，评估局部治疗对伤口周围皮肤减轻瘙痒的安全性和有效性，描述慢性伤口瘙痒的多维感觉，确定与基于个体化方法相关的特定细胞因子和趋化因子表达，并制定实用指南。
