RESUMEN
BACKGROUND: Chronic cholestatic pruritus (ChP) is caused by various hepatobiliary disorders. This retrospective study describes the distribution of underlying diseases, clinical characteristics and treatment efficacy in a consecutive collective of patients with ChP. PATIENTS AND METHODS: Extensive data from 60 patients with ChP (30 women, 30 men; mean age: 58.0 ± 17.0 years) were retrospectively statistically analyzed concerning demographic data, pruritus characteristics, and response to therapy. RESULTS: In this study population, 40.0% of the patients suffered from hepatitis B or C. Regarding the overall population, pruritus started in 50% of patients after diagnosis of the underlying hepatobiliary disorder. Only in patients with immune-mediated liver diseases did pruritus more often occur before diagnosis (p < 0.05). Only 23.3% of the patients reported an initial palmoplantar pruritus. Along with other drugs, anticonvulsants proved to be an effective treatment regime. CONCLUSIONS: In this study, viral pathogenesis was the most common cause of ChP. Other underlying diseases were represented to a lower extent in the total study population. Overall, the collected clinical parameters in each group were comparable. Thus, it was difficult to draw conclusions on the pathogenesis.
Asunto(s)
Colestasis/diagnóstico , Colestasis/terapia , Prurito/diagnóstico , Prurito/terapia , Adolescente , Distribución por Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Colestasis/epidemiología , Enfermedad Crónica , Comorbilidad , Femenino , Alemania/epidemiología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Prurito/epidemiología , Estudios Retrospectivos , Medición de Riesgo , Distribución por Sexo , Resultado del Tratamiento , Adulto JovenRESUMEN
Notalgia paraesthetica is a neuropathic pruritus on the back. The aim of this retrospective study was to examine patient characteristics in a consecutive cohort from Brazil and Germany. A total of 65 patients (49 women, 16 men; age range 25-80 years, mean 56.2 ± 12.7 years; median 57.0 years) were investigated in order to determine the spinal or peripheral origin of notalgia paraesthetica. Protein gene product 9.5-positive intraepidermal nerve fibers were significantly reduced in the pruritic compared with the non-lesional area (p < 0.05). In 32.3% of patients, radiological examinations showed a stenosis and in 47.7% a degeneration. A correlation between the radiological findings and the exact dermatomal localization of notalgia paraesthetica was found in 15.7% of the involved areas. The significant reduction in intraepidermal nerve fiber density suggests that damage to the peripheral nerves is a more important aetiological factor than spinal changes in notalgia paraesthetica.