中华皮肤科杂志 ›› 2023, Vol. 56 ›› Issue (11): 1070-1073.doi: 10.35541/cjd.20210130
程必红 窦侠
收稿日期:
2021-02-08
修回日期:
2021-09-27
发布日期:
2023-11-03
通讯作者:
窦侠
E-mail:drdouxia@163.com
基金资助:
Cheng Bihong, Dou Xia
Received:
2021-02-08
Revised:
2021-09-27
Published:
2023-11-03
Contact:
Dou Xia
E-mail:drdouxia@163.com
Supported by:
摘要: 【摘要】 慢性痒疹是独立的慢性炎症性皮肤病,患者可能存在复杂的病因或合并症,诊断需要系统的流程,包括明确核心症状,全面采集病史和体格检查,完善必要的实验室或影像学检查,以及评估疾病严重程度。治疗慢性痒疹包括处理可能的病因和并发症,以及分阶梯式地控制瘙痒。该文主要综述慢性痒疹的临床诊断、分型和治疗。
程必红 窦侠. 慢性痒疹的诊断及分型新进展[J]. 中华皮肤科杂志, 2023,56(11):1070-1073. doi:10.35541/cjd.20210130
Cheng Bihong, Dou Xia. Diagnosis and classification of chronic prurigo[J]. Chinese Journal of Dermatology, 2023, 56(11): 1070-1073.doi:10.35541/cjd.20210130
[1] | Pereira MP, Basta S, Moore J, et al. Prurigo nodularis: a physician survey to evaluate current perceptions of its classification, clinical experience and unmet need[J]. J Eur Acad Dermatol Venereol, 2018,32(12):2224⁃2229. doi: 10.1111/jdv.15107. |
[2] | Pereira MP, Zeidler C, Wallengren J, et al. Chronic nodular prurigo: a European cross⁃sectional study of patient perspectives on therapeutic goals and satisfaction[J]. Acta Derm Venereol, 2021,101(2):adv00403. doi: 10.2340/00015555⁃3726. |
[3] | Pereira MP, Hoffmann V, Weisshaar E, et al. Chronic nodular prurigo: clinical profile and burden. A European cross⁃sectional study[J]. J Eur Acad Dermatol Venereol, 2020,34(10):2373⁃2383. doi: 10.1111/jdv.16309. |
[4] | Huang AH, Canner JK, Khanna R, et al. Real⁃world prevalence of prurigo nodularis and burden of associated diseases[J]. J Invest Dermatol, 2020,140(2):480⁃483.e4. doi: 10.1016/j.jid. 2019.07.697. |
[5] | Pereira MP, Steinke S, Zeidler C, et al. European academy of dermatology and venereology European prurigo project: expert consensus on the definition, classification and terminology of chronic prurigo[J]. J Eur Acad Dermatol Venereol, 2018,32(7):1059⁃1065. doi: 10.1111/jdv.14570. |
[6] | Kwatra SG. Breaking the itch⁃scratch cycle in prurigo nodularis[J]. N Engl J Med, 2020,382(8):757⁃758. doi: 10.1056/NEJMe 1916733. |
[7] | Park K, Mori T, Nakamura M, et al. Increased expression of mRNAs for IL⁃4, IL⁃17, IL⁃22 and IL⁃31 in skin lesions of subacute and chronic forms of prurigo[J]. Eur J Dermatol, 2011,21(1):135⁃136. doi: 10.1684/ejd.2010.1196. |
[8] | Wong LS, Yen YT, Lin SH, et al. IL⁃17A induces endothelin⁃1 expression through p38 pathway in prurigo nodularis[J]. J Invest Dermatol, 2020,140(3):702⁃706.e2. doi: 10.1016/j.jid. 2019.08.438. |
[9] | Belzberg M, Alphonse MP, Brown I, et al. Prurigo nodularis is characterized by systemic and cutaneous T helper 22 immune polarization[J]. J Invest Dermatol, 2021,141(9):2208⁃2218.e14. doi: 10.1016/j.jid.2021.02.749. |
[10] | Oetjen LK, Mack MR, Feng J, et al. Sensory neurons co⁃opt classical immune signaling pathways to mediate chronic itch[J]. Cell, 2017,171(1):217⁃228.e13. doi: 10.1016/j.cell.2017.08.006. |
[11] | Zhong W, Wu X, Zhang W, et al. Aberrant expression of histamine⁃independent pruritogenic mediators in keratinocytes may be involved in the pathogenesis of prurigo nodularis[J]. Acta Derm Venereol, 2019,99(6):579⁃586. doi: 10.2340/0001 5555⁃3150. |
[12] | Pogatzki⁃Zahn EM, Pereira MP, Cremer A, et al. Peripheral sensitization and loss of descending inhibition is a hallmark of chronic pruritus[J]. J Invest Dermatol, 2020,140(1):203⁃211.e4. doi: 10.1016/j.jid.2019.05.029. |
[13] | Schuhknecht B, Marziniak M, Wissel A, et al. Reduced intraepidermal nerve fibre density in lesional and nonlesional prurigo nodularis skin as a potential sign of subclinical cutaneous neuropathy[J]. Br J Dermatol, 2011,165(1):85⁃91. doi: 10.1111/j.1365⁃2133.2011.10306.x. |
[14] | Ohanyan T, Schoepke N, Eirefelt S, et al. Role of substance P and its receptor neurokinin 1 in chronic prurigo: a randomized, proof⁃of⁃concept, controlled trial with topical aprepitant[J]. Acta Derm Venereol, 2018,98(1):26⁃31. doi: 10.2340/00015555⁃2780. |
[15] | Brune A, Metze D, Luger TA, et al. Antipruritic therapy with the oral opioid receptor antagonist naltrexone. Open, non⁃placebo controlled administration in 133 patients[J]. Hautarzt, 2004,55(12):1130⁃1136. doi: 10.1007/s00105⁃004⁃0802⁃8. |
[16] | Schedel F, Schürmann C, Metze D, et al. Prurigo. Clinical definition and classification[J]. Hautarzt, 2014,65(8):684⁃690. doi: 10.1007/s00105⁃014⁃2753⁃z. |
[17] | Pereira MP, Zeidler C, Nau T, et al. Position statement: linear prurigo is a subtype of chronic prurigo[J]. J Eur Acad Dermatol Venereol, 2019,33(2):263⁃266. doi: 10.1111/jdv.15275. |
[18] | Wallengren J. Prurigo: diagnosis and management[J]. Am J Clin Dermatol, 2004,5(2):85⁃95. doi: 10.2165/00128071⁃200405020⁃00003. |
[19] | Huang AH, Williams KA, Kwatra SG. Prurigo nodularis: epidemiology and clinical features[J]. J Am Acad Dermatol, 2020,83(6):1559⁃1565. doi: 10.1016/j.jaad.2020.04.183. |
[20] | Whang KA, Mahadevan V, Bakhshi PR, et al. Prevalence of prurigo nodularis in the United States[J]. J Allergy Clin Immunol Pract, 2020,8(9):3240⁃3241. doi: 10.1016/j.jaip.2020.05.051. |
[21] | Ständer S, Yosipovitch G, Legat FJ, et al. Trial of nemolizumab in moderate⁃to⁃severe prurigo nodularis[J]. N Engl J Med, 2020,382(8):706⁃716. doi: 10.1056/NEJMoa1908316. |
[22] | Gore Karaali M, Erdil D, Erdemir VA, et al. Evaluation of clinicopathological and treatment characteristics of 80 patients with acquired perforating dermatosis[J/OL]. Dermatol Ther, 2020,33(6):e14465. doi: 10.1111/dth.14465. |
[23] | Kestner RI, Ständer S, Osada N, et al. Acquired reactive perforating dermatosis is a variant of prurigo nodularis[J]. Acta Derm Venereol, 2017,97(2):249⁃254. doi: 10.2340/00015555⁃2492. |
[24] | 韩毓梅, 胡东艳, 李明, 等. 17例获得性反应性穿通性胶原病临床分析[J]. 中国麻风皮肤病杂志, 2018,34(12):728⁃731. |
[25] | Brenaut E, Halvorsen JA, Dalgard FJ, et al. The self⁃assessed psychological comorbidities of prurigo in European patients: a multicentre study in 13 countries[J]. J Eur Acad Dermatol Venereol, 2019,33(1):157⁃162. doi: 10.1111/jdv.15145. |
[26] | Pereira MP, Ständer S. How to define chronic prurigo?[J]. Exp Dermatol, 2019,28(12):1455⁃1460. doi: 10.1111/exd.13972. |
[27] | Ständer HF, Elmariah S, Zeidler C, et al. Diagnostic and treatment algorithm for chronic nodular prurigo[J]. J Am Acad Dermatol, 2020,82(2):460⁃468. doi: 10.1016/j.jaad.2019.07.022. |
[28] | Elmariah S, Kim B, Berger T, et al. Practical approaches for diagnosis and management of prurigo nodularis: United States expert panel consensus[J]. J Am Acad Dermatol, 2021,84(3):747⁃760. doi: 10.1016/j.jaad.2020.07.025. |
[29] | Zeidler C, Pereira MP, Dugas M, et al. The burden in chronic prurigo: patients with chronic prurigo suffer more than patients with chronic pruritus on non⁃lesional skin: a comparative, retrospective, explorative statistical analysis of 4,484 patients in a real⁃world cohort[J]. J Eur Acad Dermatol Venereol, 2021,35(3):738⁃743. doi: 10.1111/jdv.16929. |
[30] | Kwon CD, Khanna R, Williams KA, et al. Diagnostic workup and evaluation of patients with prurigo nodularis[J]. Medicines (Basel), 2019,6(4):97. doi: 10.3390/medicines6040097. |
[31] | Werbel T, Hinds BR, Cohen PR. Scabies presenting as cutaneous nodules or malar erythema: reports of patients with scabies surrepticius masquerading as prurigo nodularis or systemic lupus erythematosus[J/OL]. Dermatol Online J, 2018,24(9):13030/qt5bn8k4vx. |
[32] | Weigelt N, Metze D, Ständer S. Prurigo nodularis: systematic analysis of 58 histological criteria in 136 patients[J]. J Cutan Pathol, 2010,37(5):578⁃586. doi: 10.1111/j.1600⁃0560.2009. 01484.x. |
[33] | 朱学骏, 涂平, 陈喜雪, 等. 皮肤病的组织病理学诊断[M]. 3版. 北京: 北京大学医学出版社, 2016:63, 92⁃93. |
[34] | Ständer S, Holtsche MM, Schmidt E, et al. Presence of cutaneous complement deposition distinguishes between immunological and histological features of bullous pemphigoid⁃insights from a retrospective cohort study[J]. J Clin Med, 2020,9(12):3928. doi: 10.3390/jcm9123928. |
[35] | Abdel⁃Latif AA, Elshahed AR, Salama OA, et al. Comparing the diagnostic properties of skin scraping, adhesive tape, and dermoscopy in diagnosing scabies[J]. Acta Dermatovenerol Alp Pannonica Adriat, 2018,27(2):75⁃78. doi: 10.15570/actaapa.2018. 17. |
[36] | Hanumaiah B, Joseph JM. Role of dermoscopy in the diagnosis of hypertrophic lichen planus and prurigo nodularis[J]. Indian J Dermatol, 2019,64(5):341⁃345. doi: 10.4103/ijd.IJD_123_18. |
[37] | Li FZ, Chen S. Diagnostic accuracy of dermoscopy for scabies[J]. Korean J Parasitol, 2020,58(6):669⁃674. doi: 10.3347/kjp. 2020.58.6.669. |
[38] | Zeidler C, Pereira MP, Augustin M, et al. Investigator′s global assessment of chronic prurigo: a new instrument for use in clinical trials[J]. Acta Derm Venereol, 2021,101(2):adv00401. doi: 10.2340/00015555⁃3701. |
[39] | Pölking J, Zeidler C, Schedel F, et al. Prurigo activity score (PAS): validity and reliability of a new instrument to monitor chronic prurigo[J]. J Eur Acad Dermatol Venereol, 2018,32(10):1754⁃1760. doi: 10.1111/jdv.15040. |
[40] | Boozalis E, Tang O, Patel S, et al. Ethnic differences and comorbidities of 909 prurigo nodularis patients[J]. J Am Acad Dermatol, 2018,79(4):714⁃719.e3. doi: 10.1016/j.jaad.2018.04. 047. |
[41] | Larson VA, Tang O, Stander S, et al. Association between prurigo nodularis and malignancy in middle⁃aged adults[J]. J Am Acad Dermatol, 2019,81(5):1198⁃1201. doi: 10.1016/j.jaad.2019.03. 083. |
[42] | Huang AH, Canner JK, Kang S, et al. Analysis of real⁃world treatment patterns in patients with prurigo nodularis[J]. J Am Acad Dermatol, 2020,82(1):34⁃36. doi: 10.1016/j.jaad.2019.09. 007. |
[43] | Agelopoulos K, Rülander F, Dangelmaier J, et al. Neurokinin 1 receptor antagonists exhibit peripheral effects in prurigo nodularis including reduced ERK1/2 activation[J]. J Eur Acad Dermatol Venereol, 2019,33(12):2371⁃2379. doi: 10.1111/jdv. 15905. |
[44] | Chiricozzi A, Maurelli M, Gori N, et al. Dupilumab improves clinical manifestations, symptoms, and quality of life in adult patients with chronic nodular prurigo[J]. J Am Acad Dermatol, 2020,83(1):39⁃45. doi: 10.1016/j.jaad.2020.03.049. |
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