皮肤疾病源性瘙痒

Pruritus Associated with Dermatoses

瘙痒是一种能够引起搔抓欲望的不愉快感觉,明显降低患者的生活质量,是临床皮肤科较难解决的一个问题,瘙痒分为急性皮肤瘙痒(瘙痒持续时间小于6周)和慢性皮肤瘙痒(瘙痒持续时间为6周或者更长)。研究已经发现与皮肤瘙痒发病机制密切相关的细胞因子、趋化因子、胺类、神经肽、神经生长因子等多种内源性致痒物质以及其选择性受体。目前对于慢性皮肤疾病源性瘙痒还没有一个统一的治疗标准,要充分考虑到患者的健康状况、瘙痒的严重程度以及瘙痒治疗可能发生的不良反应,给予个体化治疗方案。瘙痒的临床治疗包括局部治疗和系统治疗,皮肤屏障功能修复是今后瘙痒治疗的重要研究方向,深入理解皮肤瘙痒的发病机制是安全有效治疗的必要前提。

Pruritus can be defined as an unpleasant cutaneous sensation associated with the immediate desire to scratch. Pruritus is a profound clinical problem that decreases quality of life. Pruritus is divided as acute when it lasts less than 6 weeks or chronic when it persists for more than 6 weeks. Recent studies have indicated that the pathogenic mechanisms of pruritus involve a number of mediators including cytokines, chemokines, histamine, neuropeptides, and nerve growth factor, as well as their receptors. At present, there is no universally accepted therapy for chronic pruritus associated with dermatoses. Management of pruritus must take an individualistically approach with consideration of the patient＇s general health ,the severity of symptoms ,and the adverse effects of treatment. Treatments for pruritus include topical therapies and systemic therapies. Epidermal barrier repair may play an important role in pruritus treatment. The development of effective treatments requires a full understanding of the fundamental mechanisms of pruritus.