Pereira Manuel Pedro, Wiegmann Henning, Agelopoulos Konstantin, Ständer Sonja
Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany.
Front Med (Lausanne). 2021 Feb 24;8:641746. doi: 10.3389/fmed.2021.641746. eCollection 2021.
Neuropathic itch occurs due to damage of neurons of the peripheral or central nervous system. Several entities, including metabolic, neurodegenerative, orthopedic, infectious, autoimmune, malignant, and iatrogenic conditions, may affect the somatosensory system and induce neuropathic itch. Due to the complex nature of neuropathic itch, particularly concerning its clinical presentation and possible etiological factors, diagnostic work-up of this condition is challenging. A detailed medical history, especially in regard to the itch, and a comprehensive physical examination are relevant to detect characteristic signs and symptoms of neuropathic itch and to rule out other possible causes for chronic itch. Complementary diagnostic exams, especially laboratory tests, determination of the intraepidermal nerve fiber density via a skin biopsy and radiological examinations may be indicated to confirm the diagnosis of neuropathic itch and to identify underlying etiological factors. Functional assessments such as quantitative sensory testing, nerve conduction studies, evoked potentials, or microneurography may be considered in particular cases. This review article provides a comprehensive overview of the diagnostic work-up recommended for patients with neuropathic itch.
神经性瘙痒是由于外周或中枢神经系统的神经元受损而发生的。包括代谢性、神经退行性、骨科、感染性、自身免疫性、恶性和医源性疾病在内的多种情况，可能会影响躯体感觉系统并诱发神经性瘙痒。由于神经性瘙痒的性质复杂，尤其是在其临床表现和可能的病因方面，对这种疾病的诊断检查具有挑战性。详细的病史，特别是关于瘙痒的病史，以及全面的体格检查，对于发现神经性瘙痒的特征性体征和症状以及排除慢性瘙痒的其他可能原因至关重要。可能需要进行辅助诊断检查，特别是实验室检查、通过皮肤活检测定表皮内神经纤维密度以及放射学检查，以确诊神经性瘙痒并确定潜在的病因。在特定情况下，可考虑进行功能评估，如定量感觉测试、神经传导研究、诱发电位或微神经ography检查。这篇综述文章全面概述了针对神经性瘙痒患者推荐的诊断检查。
