Misery Laurent
Univ Brest, LIEN, Brest, France.
Front Med (Lausanne). 2021 Jan 20;7:615118. doi: 10.3389/fmed.2020.615118. eCollection 2020.
The International Association for the Study of Pain (IASP) defined three descriptors for pain: nociceptive pain is "pain that arises from actual or threatened damage to non neural tissue and is due to the activation of nociceptors"; neuropathic pain is "pain caused by a lesion or disease of the somatosensory nervous system"; and nociplastic pain is "pain that arises from altered nociception despite no clear evidence of actual or threatened tissue damage causing the activation of peripheral nociceptors or evidence for disease or lesion of the somatosensory system causing the pain." Based on clinical and pathophysiological arguments, a similar definition of "pruriplastic pruritus" should be made. Pruriplastic pruritus would include psychogenic pruritus, as well as some cases of pruritus ani, vulvar pruritus, sensitive skin or other poorly understood cases of pruritus. This new descriptor of itch could serve as systematic screening for altered pruriceptive function in patients who suffer from chronic itch and it may also help in defining better tailored treatment by identifying patients who are likely to respond better to centrally rather than to peripherally targeted therapies.
国际疼痛研究协会（IASP）为疼痛定义了三种描述：伤害性疼痛是“由对非神经组织的实际或潜在损伤引起的疼痛，归因于伤害感受器的激活”；神经性疼痛是“由躯体感觉神经系统的损伤或疾病引起的疼痛”；而神经可塑性疼痛是“尽管没有明确证据表明实际或潜在的组织损伤导致外周伤害感受器激活，或没有证据表明躯体感觉系统的疾病或损伤导致疼痛，但仍由伤害感受改变引起的疼痛”。基于临床和病理生理学依据，应给出“瘙痒可塑性瘙痒”的类似定义。瘙痒可塑性瘙痒将包括精神性瘙痒，以及一些肛门瘙痒、外阴瘙痒、皮肤敏感或其他难以理解的瘙痒病例。这种新的瘙痒描述可用于对慢性瘙痒患者的瘙痒感受功能改变进行系统筛查，还可能有助于通过识别可能对中枢而非外周靶向治疗反应更好的患者来确定更有针对性的治疗方案。
