Pruritus


Which one of the following is not true


A. Bile stasis itching is a type of neuropathic pruritus
B. There is no nerve damage is neurogenic pruritus
C. Atopic dermatitis (AD) is a typical disease involving both skin derived itching and neurogenic pruritus
D. Urticaria is produced and irritated by the conduction of C nerve fiber



All are true regarding mechanisms of mediator-related pruritus except


A. Histamine increases the calcium influx in the axon terminals of the spinal cord neurons to promote a series of intracellular signal activation
B. Serotonin indirectly facilitates itching generation by encouraging mast cells to release histamine
C. Proteases are extremely important substances in causing histamine-dependent pruritus
D. IL-2 and IL-6 are the typical histamine-dependent mediators of pruritus



Palmitoylethanolamine (PEA) is an antipruritic drug which acts on following mediators


A. Leukotrienes (LTs)
B. Platelet-activating factor (PAF)
C. Cannabinoids
D. Substance-P (SP)



Not true of Pruritus in Psoriasis is


A. Most of antipruritic drugs have little effect on this symptom
B. 80% of psoriasis is accompanied with pruritic symptom
C. Itching often lasts for a long time, especially in day light
D. Ultraviolet B (UVB) has an ability of relieving pruritus



Not true of pruritic symptoms is


A. Cholestatic Pruritus starts in the foot joint and palm
B. Diabetic Pruritus can be associated with xerosis cutis
C. Antihistamines are highly effective for uremic pruritus
D. Senile pruritus is a physiological pruritus resulting from skin atrophy



In short


Pregabalin


Pregabalin is quite useful in the control of treatment-resistant uremic pruritus by decreasing the calcium influx at the nerve endings and the level of SP, glutamate, and noradrenaline.


Opioid receptor antagonist


The opioid receptor antagonist is the first choice of treatment for cholestatic pruritus.


Pregnancy


Some specific dermatoses are easily seen in different time during pregnancy, such as prurigo and folliculitis often occurring in second trimester of pregnancy and urticaria in third trimester


Doxepin


Doxepin is the most useful topical antihistamine.


Corticosteroids


Corticosteroids are often used in relief of pruritus from dermatoses caused by itchy mediators, but they should be used only for a short interval, because long-term use would make skin atrophy and dry.


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