University of Connecticut School of Medicine, 263 Farmington Ave., Farmington, CT, 06030, USA.
Department of Anesthesiology and Pain Medicine, Yale University School of Medicine, 333 Cedar Street TMP3, New Haven, CT, 06510, USA.
Curr Pain Headache Rep. 2021 Apr 6;25(6):38. doi: 10.1007/s11916-021-00955-2.
Pain management in dermatologic conditions can be complicated by the primary disease burden and associated decreased quality of life, disability, and psychosocial issues. This review focuses on pain management strategies in some of the more painful dermatologic conditions.
Pain management in painful dermatologic conditions such as pyoderma gangrenosum, postherpetic neuralgia, lower limb ulcers, and hidradenitis suppurativa revolves around treatment of the underlying disease process. Topical agents such as topical steroids and systemic immunosuppressants with over-the-counter analgesics usually suffice in mild to moderate pain. Severe pain may need neuropathic agents and referral to interventional pain physicians for consideration of advanced techniques such as epidural steroid injections and sympathetic nerve blocks. Part of the treatment process is for dermatologists to establish patient expectations and to treat pain within their scope of practice. More research is needed towards pain control in painful dermatologic conditions with elucidation of treatment algorithms unique to each condition.
皮肤病相关疼痛的管理可能因基础疾病负担、生活质量下降、残疾和心理社会问题而变得复杂。本文主要关注某些更疼痛的皮肤病的疼痛管理策略。
坏疽性脓皮病、带状疱疹后神经痛、下肢溃疡和化脓性汗腺炎等疼痛性皮肤病的疼痛管理围绕着基础疾病过程的治疗。轻度至中度疼痛通常可以使用外用类固醇和全身性免疫抑制剂等局部药物联合非处方止痛药。严重疼痛可能需要使用神经病理性药物,并转介给介入疼痛医师,考虑使用硬膜外类固醇注射和交感神经阻滞等先进技术。皮肤科医生的治疗过程之一是确定患者的预期,并在其治疗范围内治疗疼痛。需要进一步研究每种疾病特有的疼痛控制治疗算法,以改善疼痛性皮肤病的疼痛控制。