Clinical Relevance of Skin Pain in Atopic Dermatitis.

Clinical Relevance of Skin Pain in Atopic Dermatitis. J Drugs Dermatol. 2020 Oct 01;19(10):921-926 Authors: Ständer S, Simpson EL, Guttman-Yassky E, Thyssen JP, Kabashima K, Ball SG, Rueda MJ, DeLozier AM, Silverberg JI Abstract Skin pain is increasingly recognized as an impactful symptom in atopic dermatitis (AD) because of its association with patient discomfort, disease burden, and reduced quality of life. Although the nature of skin pain in AD has not been systematically studied and is therefore not well understood, patients report soreness, discomfort, and tenderness that may reflect peripheral and central pain sensitization. The high prevalence of skin pain suggests that it is not adequately addressed by current therapies for AD and may be undertreated compared with other symptoms. This review discusses the clinical relevance of skin pain with respect to its experience, pathophysiology, relationship with itch, and treatment implications. Recent studies suggest that skin pain presents as a neuropathic symptom independent from itch and the “itch-scratch cycle”, and poses a unique burden to patients. Recognition of the significant consequences of skin pain and discomfort should reinforce the need to assess and treat this symptom in patients with moderate-to-severe AD. J Drugs Dermatol. 2020;19(10)921-926. doi:10.36849/JDD.2020.5498. PMID: 33026764 [PubMed - as supplied by publisher]
Source: Journal of Drugs in Dermatology - Category: Dermatology Tags: J Drugs Dermatol Source Type: research

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CONCLUSIONS: In patients with AD, quality of life was most affected in patients with lesions in visible areas, including head/neck, hands/fingers, and upper extremities, with statistically significant associations for a number of DLQI domains. Physicians should be aware of the burden of AD lesions on QoL and consider having conversations with patients to better understand the impact of these lesions. Prior presentation: 28th Annual European Academy of Dermatology and Venereology Congress; 9–13 October 2019, Madrid, Spain. Poster number P0233.J Drugs Dermatol. 2020;19(10): 943-948. doi:10.36849/JDD.2020.5422. PMID...
Source: Journal of Drugs in Dermatology - Category: Dermatology Tags: J Drugs Dermatol Source Type: research
Atopic dermatitis (AD) is a chronic inflammatory skin disease with a prevalence of 5-10% among adults in the United States, and approximately 4% among adults in Europe.1,2 AD is associated with up-regulation of type 2 immune responses (including those involving type 2 helper T cells) and skin barrier dysfunction.3-7 Clinical characterization includes the presence of pruritus (itch) and eczematous lesions, with itching, skin pain, sleep and mental health disturbances among the most common patient complaints.
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Source Type: research
Atopic dermatitis (AD) is associated with itch, pain, sleep disturbance and systemic inflammation, all of which may contribute toward cognitive dysfunction. We sought to characterize the patient-burden of cognitive dysfunction in adult AD. We performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist (n=203). AD severity was assessed using patient-reported global AD severity, Patient-Oriented Eczema Measure (POEM), Numeric Rating Scale (NRS) for worst-itch and skin-pain, Dermatology Life Quality Index (DLQI), ItchyQOL, Eczema Area and Severity Index (EASI), objective and...
Source: Journal of Investigative Dermatology - Category: Dermatology Authors: Tags: Patient-Targeted Research Source Type: research
​Emergency providers expeditiously sift and sort patients on their shifts and streamline procedures like how to place an ear wick in a patient with otitis externa, a quick and useful procedure for a patient who will reap the rewards.Standard ear wicks. The material is made from a dehydrated sponge composed of hydroxylated poly(vinyl acetate). It increases in size when liquid is applied. Photo by M. Roberts.Otitis externa can cause significant swelling, irritation, pruritis, and pain to the ear canal. Occasionally, the canal is so swollen it may be difficult to administer ear drops. An ear wick can be inserted between the...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Atopic dermatitis (AD) is associated with itch, pain, and sleep disturbance, all of which may contribute toward cognitive dysfunction.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Authors: Source Type: research
ConclusionsQualitative data from NLP, being more patient-centric than data from clinical standardized measures, provide a more comprehensive view of the burden of AD to inform disease management.
Source: Dermatology and Therapy - Category: Dermatology Source Type: research
In this study, we investigated the mechanisms for the activation of itch-responsive GRPR+ neurons in the spinal dorsal horn (SDH). GRPR+ neurons expressed the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) containing the GluR2 subunit. In mice, peripherally elicited histaminergic and non-histaminergic itch was prevented by intrathecal (i.t.) administration of the AMPAR antagonist NBQX, which was consistent with the fact that firing of GRPR+ neurons in SDH under histaminergic and non-histaminergic itch was completely blocked by NBQX, but not by the GRPR antagonist RC-3095. Because GRP+ neurons i...
Source: Neuropharmacology - Category: Drugs & Pharmacology Authors: Tags: Neuropharmacology Source Type: research
AbstractAtopic dermatitis (AD) in older adults (elderly AD) has recently emerged as a newly defined subgroup of AD. When selecting treatment options, clinical characteristics of elderly AD and age-specific factors of older patients must be considered. As in other age groups, regular application of moisturizers in combination with topical corticosteroids and calcineurin inhibitors, adjunctive administration of oral antihistamines/anti-allergic drugs, and avoidance of exacerbating factors comprise basic treatments for elderly AD. For moderate-to-severe cases and/or in those with a decreased ability to use topical treatments,...
Source: Drugs and Aging - Category: Geriatrics Source Type: research
Authors: Kaaz K, Szepietowski JC, Matusiak Ł Abstract Chronic dermatoses, including atopic dermatitis, psoriasis, prurigo nodularis, chronic spontaneous urticaria and hidradenitis suppurativa, as well as accompanying subjective symptoms (itch and pain), have a great impact on patients' well-being. Skin plays an important role in the physiological sleep process. This review attempts to analyze the association between chronic dermatoses in adults and sleep quality in recent studies. Polysomnography and actigraphy are performed for the objective assessment of sleep quality. Questionnaire-based subjective evaluations ...
Source: Advances in Dermatology and Allergology - Category: Dermatology Tags: Postepy Dermatol Alergol Source Type: research
aller AS, Wollenberg A, Reich K Abstract BACKGROUND: Baricitinib, an oral selective Janus kinase 1 and 2 inhibitor, effectively reduced atopic dermatitis (AD) severity in a Phase 2 study with concomitant topical corticosteroids. OBJECTIVES: To evaluate the efficacy and safety of baricitinib in patients with moderate-to-severe AD and an inadequate response to topical therapies. METHODS: In two independent, multicentre, double-blind, Phase 3 monotherapy trials, BREEZE-AD1 and BREEZE-AD2, adults with moderate-to-severe AD were randomised 2:1:1:1 to once-daily placebo, baricitinib 1-mg, 2-mg or 4-mg for 16 w...
Source: The British Journal of Dermatology - Category: Dermatology Authors: Tags: Br J Dermatol Source Type: research
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