Department of Dermatology, National Medical Center, Seoul, Republic of Korea.
Sci Rep. 2020 Jan 23;10(1):1022. doi: 10.1038/s41598-020-57629-z.
Chronic pruritus of unknown origin (CPUO) is defined as itching lasting more than 6 weeks in the absence of discernible skin lesions. Pregabalin is used to treat patients with CPUO. In this study, we aimed to investigate differences in the perception threshold of itch sensation between patients with CPUO and healthy individuals and to evaluate the efficacy of pregabalin for CPUO. At baseline, week 2, and week 4 after treatment initiation, the visual analogue scale (VAS) score was measured to assess pruritus severity, and electric current perception threshold (CPT) was measured at 250 and 5 Hz using a NEUROMETER CPT/C stimulator. Twenty healthy individuals and 41 patients with CPUO were enrolled in this study. The patients with CPUO were categorised as those who responded to antihistamines (Antihistamine group), were not improved by antihistamines (Pregabalin group), and were not improved by antihistamines and pregabalin (Refractory group). The baseline CPT values were not significantly different between patients with CPUO and healthy control. Pruritus was improved in 7 of 10 patients in the Pregabalin group after treatment with pregabalin, showing decreased CPT at 5 Hz. The sensitive C-fibres presented a high threshold to detect itch sensation, and this sensitivity decreased in response to treatment with pregabalin.
慢性不明原因瘙痒症(CPUO)定义为无明显皮肤损伤的瘙痒持续 6 周以上。加巴喷丁用于治疗 CPUO 患者。本研究旨在探讨 CPUO 患者与健康个体之间瘙痒感觉感知阈值的差异,并评估加巴喷丁治疗 CPUO 的疗效。在治疗开始时的基线、第 2 周和第 4 周,使用视觉模拟量表(VAS)评分评估瘙痒严重程度,并使用 NEUROMETER CPT/C 刺激器在 250 和 5 Hz 下测量电流感知阈值(CPT)。本研究纳入了 20 名健康个体和 41 名 CPUO 患者。将 CPUO 患者分为对抗组胺药有反应的患者(抗组胺组)、对抗组胺药无改善的患者(加巴喷丁组)和对抗组胺药和加巴喷丁均无改善的患者(难治性组)。CPUO 患者与健康对照组的基线 CPT 值无显著差异。加巴喷丁治疗后,加巴喷丁组 10 例患者中的 7 例瘙痒得到改善,5 Hz 时 CPT 降低。敏感 C 纤维对瘙痒感觉的检测具有较高的阈值,而这种敏感性在接受加巴喷丁治疗后降低。