Navarro-Triviño F J
Unidad de Eczema de Contacto e Inmunoalergia, Dermatología, Hospital Universitario San Cecilio, Granada, Spain.
Actas Dermosifiliogr. 2023 Jun;114(6):T512-T522. doi: 10.1016/j.ad.2023.05.013. Epub 2023 May 10.
Pruritus is the most common symptom of dermatologic and systemic diseases. The diagnosis of pruritus is clinical, although additional tests may be necessary to identify or confirm the cause. Translational medicine has led to the discovery of new mediators of itch, or pruritogens, as well as new receptors. Knowing how to properly recognize the main pathway that mediates itch in each patient is the key to successful treatment. Although the histaminergic pathway predominates in conditions like urticaria or drug-induced pruritus, it is the nonhistaminergic pathway that predominates in nearly all other skin diseases covered in this review. Part 1 of this 2-part review discusses the classification of pruritus, additional testing, the pathophysiology of itch and the pruritogens implicated (including cytokines and other molecules), and central sensitization to itch.
瘙痒是皮肤病和全身性疾病最常见的症状。瘙痒的诊断基于临床症状,不过可能需要进行额外检查以识别或确认病因。转化医学已促成了新的瘙痒介质(即致痒原)以及新受体的发现。了解如何准确识别每位患者中介导瘙痒的主要途径是成功治疗的关键。尽管组胺能途径在荨麻疹或药物性瘙痒等病症中占主导地位,但在本综述涵盖的几乎所有其他皮肤病中,非组胺能途径才是主要的。本两部分综述的第1部分讨论了瘙痒的分类、额外检查、瘙痒的病理生理学以及涉及的致痒原(包括细胞因子和其他分子),还有对瘙痒的中枢敏化。