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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The role of psychosocial stress in the etiology and clinical course of psoriasis and atopic dermatitis still remains to be elucidated. In this study, we assessed neuroendocrine, dermatological, and cognitive responses in healthy subjects and in subjects suffering from psoriasis and atopic dermatitis, respectively. Perceived stress increased the most in psoriatics during the stressor exposure but tended to return faster to baseline in this group than was found for atopics and healthy controls. Growth hormone secretion was attenuated during stress in patients with skin disorders. Overall, neuroendocrine reactivity was similar in the three groups. Dermal flare reactivity was enhanced in healthy controls but perceived itch enhanced in atopics in response to stress. Stress per se was not an important discriminator between groups. Coping style and other cognitive factors turned out to be of significant importance to predict skin reactivity rather than a specific skin disease. The study suggests that psychosocial stress affects the skin reactivity and that cognitive factors modulate such effects. However, a specific skin condition explains only a fraction of the overall variance in skin reactivity to specific stressors.
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PMID:Endocrine and dermatological concomitants of mental stress. 204 85

The most commonly encountered vulvar dermatoses present as cutaneous papules or scaly plaques. The two major categories are the papulosquamous disorders, which include psoriasis, seborrhoea and the 'lichens' (lichen planus, lichen sclerosus, lichen simplex chronicus) and chronic or recurrent infections (tinea, Candida, papillomavirus, herpes simplex). These conditions are morphologically similar, and treatment for one condition may affect the appearance of another. Lichen simplex chronicus (LSC, histologically squamous cell hyperplasia) is a secondary dermatosis, a non-specific cutaneous change indicating the presence of pruritus. Candida, tinea, lichen sclerosus, papillomavirus and topical agents have all been implicated in the development of LSC. Chronic vulvar burning (vulvodynia) is rarely associated with cutaneous change other than erythema, but may occur with vulvar dermatoses, occult Candida or papillomavirus infection, vulvar vestibulitis or cutaneous dysaesthesias. Topical preparations are most commonly used to treat vulvar disorders. Treatment trials typically require several weeks of therapy to determine responses. Allergic reactions to components must be distinguished from irritants, and complications of therapy must be recognised and prevented if possible. Overuse of topical medications, especially steroids, may lead to mycotic superinfection or to rebound dermatoses related to steroid withdrawal. Anxious patients may overclean or overtreat sensitive genital skin in the belief that they are unclean or harbour a sexually transmitted disease. In some situations, systemic medication may offer an appropriate adjunct or alternative to topical therapy.
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PMID:Vulvar dermatoses: common problems in dermatological and gynaecological practice. 209 34

A total of 80 patients with chronic, stable psoriasis, 34 of whom also had psoriatic arthritis, were treated with 1122 mg/day eicosapentaenoic acid ethyl ester and 756 mg/day docosahexaenoic acid ethyl ester. Before the study and after 4 and 8 weeks of treatment a Psoriatic Association scoring index (PASI) score was assessed. Before treatment the mean PASI score was 3.56, after 4 weeks 1.98 and after 8 weeks 1.24; the decrease in the score was highly significant (P less than 0.001). The degree of pruritus decreased most rapidly, followed by scaling and induration of the plaques, and erythema was most persistent. At the end of the trial, seven patients were completely healed and in 13 other patients more than 75% healing was observed but in 14 patients the result was poor. The majority of patients with psoriatic arthritis reported a subjective improvement in joint pain during the study. It is concluded that polyunsaturated ethyl ester lipids may be useful for the treatment of psoriasis and psoriatic arthritis and may provide an important adjuvant to standard therapy of both conditions.
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PMID:Effects of dietary supplementation with polyunsaturated ethyl ester lipids (Angiosan) in patients with psoriasis and psoriatic arthritis. 213 59

Ten patients with psoriasis were treated for three days with salicylic acid ointment with vaseline vehicle. In all patients the serum concentration of salicylic acid increased systematically and the concentration depended on the amount of ointment used and on psoriasis form. Only in one case of exudative psoriasis the level of salicylic acid reached the value causing intoxication, and produced a diffuse inflammatory erythema with itching. The treatment caused no changes of biochemical indices.
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PMID:[Serum levels of salicylic acid in patients with psoriasis treated with 10% salicylic acid ointment]. 220 78

The contribution of psychosomatic factors toward the morbidity associated with psoriasis should be evaluated in the context of the patient's developmental stage and life situation. The skin, as a sensory organ, plays a critical role in an individual's physical and emotional growth in early life. The skin also plays an integral role as an organ of communication throughout life and greatly affects an individual's body image and self-esteem. If these factors are not taken into consideration, the morbidity associated with psoriasis may increase, or the patient may remain dissatisfied with treatment even in the face of clinically satisfactory treatment outcome. Some recent studies indicate that the adverse impace of psoriasis upon the quality of life can result in significant chronic stress, which may in turn exacerbate the psoriasis in a subgroup of patients. As disease-related stress is present in every patient to some degree, the dermatologist should regularly assess the psychosocial impact of the disease. Certain personality factors, such as a tendency to want the approval of others and difficulty with assertion of angry feelings, may make the patient with psoriasis more vulnerable to stress and contribute toward the stress reactivity of the disease. The presence of depression in psoriasis may modulate itch perception, exacerbate pruritus, and lead to difficulties with initiating and maintaining sleep. Helping the patient to develop assertiveness skills in addition to supportive psychotherapy may facilitate the patient's capacity to cope with the daily stresses associated with psoriasis. Treatment of depressive symptoms may prove to be a helpful adjunct in the management of pruritus and sleep difficulties in psoriasis.
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PMID:Some psychosomatic aspects of psoriasis. 220 73

In this paper attention is focused on the following conditions: perianal skin problems such as pruritus in the perianal area, the eczemas, psoriasis, premalignant and malignant tumours such as Bowen's disease and Bowenoid papulosis, squamous cell carcinoma, dermatophyte and yeast infections and sexually transmitted diseases such as syphilis, condylomata acuminata (warts) and genital herpes. Principles of clinical, bacteriological and histopathological diagnosis will be discussed briefly for each of the above-mentioned diseases. For some of these, therapeutic effectiveness and particular side effects due to the use of topically applied drugs containing corticosteroids, anaesthetics, antibiotics and preservatives will also be considered.
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PMID:General perianal skin problems. 223 34

338 patients with psoriasis (male: 213, female: 125) who have been treated in our department from 1979 to 1988 answered a questionnaire concerning social and psychological effects of the disease. The mean age of onset was 33 years; 35 years for the male and 29 years for the female. Social and emotional morbidity was present for many patients despite the access to modern treatments. The worst feeling about having psoriasis was general appearance of the skin (41.7%), itching (19.5%), flaking of the skin (16.9%) and time-consuming or messy treatment programs (13.3%). A large percentage of patients avoided common social activities, for example, communal baths, swimming, and sports. Triggering factors of psoriasis were climate (60.3%), stress (46.9%), sleeping disturbance (34.6%), irregular life (32.2%), and low humidity (22.5%). 18.6% of patients were affected in choosing the occupation by having psoriasis. Many patients felt stigmatized as the disease is contagious or genetic. Most of the patients learned psoriasis through doctors, however, 75.7% of them wanted to get more informations. Finally, since only 26.3% of patients were satisfied with current therapeutics, dermatologists seem to be too self satisfied with present managements. It is important for us to understand what the patients are really suffering from and what the patients really want. And, it also is important to make efforts for a better understanding of psoriasis in society.
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PMID:[A survey of the social and psychological effects of psoriasis]. 227 79

The effects on the hypothalamic-pituitary-adrenal axis of the ultra-high potency corticosteroid halobetasol in the treatment of psoriasis were evaluated in seven patients with extensive, long-standing plaque psoriasis. Each patient applied 3.5 g halobetasol 0.05% ointment in the morning and evening for 7 days. Morning plasma cortisol levels and 24-hour urinary excretion of 17-hydroxycorticosteroid were determined before and on the last 2 days of treatment; plasma cortisol levels were also determined 4 and 5 days after completion of therapy. Morning plasma cortisol concentrations did not decrease significantly during treatment, and no values were below the normal range. Mean 24-hour urinary 17-hydroxycorticosteroid excretion fell from 6.6 +/- 1.4 mg to 5.1 +/- 1.4 mg. Two patients had mild, localized pruritus and stinging with the initial ointment application. No other adverse cutaneous effects were observed. Halobetasol was also clinically efficacious over the 7 days of treatment, based on evaluation of pruritus, erythema, scaling, and plaque elevation. These results demonstrate no adverse effects of the drug on the hypothalamic-pituitary-adrenal axis at doses that are clinically effective in the management of plaque psoriasis.
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PMID:The safety of halobetasol 0.05% ointment in the treatment of psoriasis. 234 35

The majority of patients with idiopathic pruritus ani respond favorably to conservative treatment. Moreover, response to specific medical therapy is almost always favorable in certain dermatologic diseases such as psoriasis, mycotic dermatitis, and contact dermatitis. When surgery is performed for anorectal disorders such as hemorrhoids and fistulas, or potentially malignant entities such as extramammary Paget's disease, the accompanying pruritus ani invariably improves as well. Only patients with chronic intractable pruritus ani are included in the current study. Methylene blue (methylthionine chloride) 0.5 percent is injected intracutaneously on the anodermal and perianal skin. With one treatment, long-term cure has been observed.
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PMID:Treatment of intractable pruritus ani. 239 Sep 13

A case of inflammatory linear verrucous epidermal nevus (ILVEN) is reported. Short contact treatment with dithranol resulted in complete relief from itching and a remarkable clearing of all linear lesions except from a small verrucous band on the shin. In patients with ILVEN it is advisable to try dithranol therapy before carrying out surgical procedures such as excision, cryotherapy, electrocautery. The prompt response to dithranol is best explained by the assumption that most of the lesions in this case of ILVEN represented true linear psoriasis.
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PMID:Dithranol in the treatment of inflammatory linear verrucous epidermal nevus. 256 15


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