Pruritus, Prurigo and Lichen Simplex

Sonja Ständer, Malcolm Greaves


Chronic pruritus (of more than 6 weeks duration) is one of the most frequent and burdensome of symptoms, occurring not only in association with a variety of dermatoses but also in other medical specialities, such as neurology, gynaecology and psychiatry. Prurigo nodularis and lichen simplex are characterized by a vicious circle of repeated scratching and pruritus, and represent cutaneous reaction patterns with a high negative impact on patients' quality of life. During the past two decades, new insights have been gained on specific neurons, receptors and mediators that are exclusively involved in the mediation of pruritus and not of pain. Diagnostic work‐up of chronic pruritus, prurigo nodularis and lichen simplex is challenging and time‐consuming, and management of the conditions remains difficult and unsatisfactory. The mainstays of treatment to date are antihistamines, anticonvulsants and certain antidepressants. Better understanding of the underlying pathophysiology of pruritus has enabled novel treatment approaches that target the pruritus‐specific mechanisms. Current knowledge on treatment is summarized for the first time in the European Guideline on Chronic Pruritis.
Keywords pruritus, itch, prurigo nodularis, prurigo, lichen simplex chronicus


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