Department of Dermatology, University Hospital Basel, Basel, Switzerland.
Department of Haematology, University Hospital Basel, Basel, Switzerland.
J Eur Acad Dermatol Venereol. 2023 Jul;37(7):1276-1283. doi: 10.1111/jdv.19057. Epub 2023 Apr 5.
Pruritus is a common symptom of cutaneous graft-versus-host disease (GVHD) following haematopoietic stem cell transplantation (HSCT). However, little is known about its prevalence, pathophysiology, perceptual characteristics, impact on quality of life and response to antipruritic therapies. The aim of this review was to determine the current knowledge on pruritus in cutaneous GVHD. The review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses statement. Of the 338 studies screened, 13 were included. The prevalence of pruritus in cutaneous GVHD was reported in three studies, ranging from 37.0% to 63.8%. Only four trials used pruritus assessment tools. There was little or no information on the intensity of pruritus, its qualitative perception, the location of pruritus and the impact of pruritus on quality of life. Antipruritic treatments for GVHD-associated pruritus were mentioned in five studies (38.5%), including topical ointments (steroids, tacrolimus and calcipotriene), broadband UVB, systemic antihistamines and oral ursodeoxycholic acid. In conclusion, pruritus in cutaneous GVHD appears to be common, but very little is known about the pathophysiology, impact on quality of life and effective treatment options. Basic research and controlled clinical trials are warranted to improve knowledge and management of this important issue.
瘙痒是造血干细胞移植（HSCT）后皮肤移植物抗宿主病（GVHD）的常见症状。然而，人们对其患病率、病理生理学、知觉特征、对生活质量的影响以及对止痒治疗的反应知之甚少。本综述的目的是确定目前关于皮肤 GVHD 瘙痒的知识。综述按照系统评价和荟萃分析的首选报告项目进行。在筛选的 338 项研究中，有 13 项被纳入。三项研究报告了皮肤 GVHD 瘙痒的患病率，范围为 37.0%至 63.8%。只有四项试验使用了瘙痒评估工具。关于瘙痒的强度、定性知觉、瘙痒部位以及瘙痒对生活质量的影响，信息很少或没有。五项研究（38.5%）提到了 GVHD 相关瘙痒的止痒治疗，包括局部软膏（类固醇、他克莫司和卡泊三醇）、宽谱 UVB、全身抗组胺药和口服熊去氧胆酸。总之，皮肤 GVHD 中的瘙痒似乎很常见，但对其病理生理学、对生活质量的影响和有效治疗选择知之甚少。需要进行基础研究和对照临床试验，以提高对这一重要问题的认识和管理。
