Dr Phillip Frost Department of Dermatology and Miami Itch Center, University of Miami, Miami, FL, USA.
Department of Dermatology and Pediatrics, George Washington University, Washington, DC, USA.
J Eur Acad Dermatol Venereol. 2022 Dec;36(12):2279-2290. doi: 10.1111/jdv.18408. Epub 2022 Jul 21.
Itch is the most common skin symptom among tropical parasitic diseases (TPD), but there are limited data about its characteristics in these conditions. In dermatology practices and travellers' health clinics in the developed world, itch is a common complaint among travellers returning from endemic areas, as well among migrants arriving from endemic areas, where they may have been exposed to TPD. Studying aspects of pruritus among TPD may lead to improvements in prompt, accurate diagnosis and management of these conditions. This review examines the major itch-inducing TPDs, including schistosomiasis, echinococcosis, onchocerciasis, scabies, cutaneous larva migrans, larva currens, African trypanosomiasis, dracunculiasis and other causes of travel associated pruritus. We focus on the link between pruritus and other symptoms, aetiology, clinical staging and therapeutic options for these parasitic illnesses. Because some tropical parasitic diseases can present with significant pruritus, we attempt to identify aspects of the pruritus that are characteristic of-or unique to-specific conditions. These diagnostic insights may help clinicians create a rational and focused differential diagnosis and help determine optimal disease management pathways. In this sense, management involves treating the individual, seeking epidemiologically linked cases, preventing recurrences or relapses, and reducing spread of the disease.
瘙痒是热带寄生虫病（TPD）中最常见的皮肤症状，但关于这些疾病中瘙痒特征的数据有限。在发达国家的皮肤科诊所和旅行者健康诊所中，从流行地区返回的旅行者以及从流行地区移民的人中，瘙痒是常见的抱怨，他们可能接触过 TPD。研究 TPD 瘙痒的各个方面可能有助于改善这些疾病的快速、准确诊断和管理。本综述检查了主要的引起瘙痒的 TPD，包括血吸虫病、包虫病、盘尾丝虫病、疥疮、游走性幼虫疹、匐行疹、非洲锥虫病、麦地那龙线虫病和其他与旅行相关的瘙痒原因。我们专注于瘙痒与其他症状之间的联系、病因、临床分期和这些寄生虫病的治疗选择。因为有些热带寄生虫病会出现明显的瘙痒，我们试图确定瘙痒的特征，这些特征是特定疾病特有的。这些诊断见解可以帮助临床医生制定合理、重点突出的鉴别诊断，并有助于确定最佳疾病管理途径。从这个意义上说，管理涉及治疗个体、寻找具有流行病学联系的病例、预防复发或再次发作，以及减少疾病传播。
