Increased touch‐evoked itch (punctate hyperknesis) in postherpetic itch: Implications of reduced intraepidermal nerve fibers representing small fiber neuropathy
Increased touch‐evoked itch (punctate hyperknesis) in postherpetic itch: Implications of reduced intraepidermal nerve fibers representing small fiber neuropathy
复制标题
DOI：
10.1111/1346-8138.16627
复制
发表时间：
2022-11
期刊：
影响因子：
--
通讯作者：
T. Hashimoto;Manami Okuzawa;M. Yamamoto;Satoshi Okuno;T. Satoh
中科院分区：
文献类型：
--
作者：
T. Hashimoto;Manami Okuzawa;M. Yamamoto;Satoshi Okuno;T. Satoh
慢性瘙痒病症通常伴有神经瘙痒敏化，称为感觉过敏（由通常仅引起轻度瘙痒或疼痛的刺激引起的过度瘙痒）和感觉异常（由光触觉刺激引起的相当大的瘙痒）。带状疱疹（带状疱疹）可引起神经性瘙痒（带状疱疹后瘙痒），尽管尚不清楚是否有运动过度伴随带状疱疹后瘙痒。作者报告了5例带状疱疹后瘙痒患者，与对侧部位相比，受累皮肤区域的触觉诱发瘙痒（点状感觉过敏）增加。从两名患者收集的皮肤活检标本显示，组织病理学检测到受影响皮肤区域的表皮内神经纤维减少，反映了小C/Aδ纤维神经病变。在1例病例中，在未使用任何药物的情况下，6个月后观察到瘙痒改善，并且受影响部位和对侧部位的触摸诱发瘙痒水平相当，同时通过受影响部位的再活检证明表皮内神经纤维恢复。表皮内神经纤维减少可能是带状疱疹后瘙痒及其相关的点状感觉过敏的促发因素之一。
Chronic itch conditions are often accompanied by neural itch sensitization, known as hyperknesis (excessive itch induced by stimuli that would normally induce only mild itching or pain) and alloknesis (considerable itch evoked by light tactile stimuli). Herpes zoster (shingles) can cause neuropathic itch (postherpetic itch), although it is unknown whether hyperknesis accompanies postherpetic itch. The authors report five patients with postherpetic itch who showed increased touch‐evoked itch (punctate hyperknesis) in the affected skin areas compared with the contralateral site. Collected skin biopsy specimens from two patients showed histopathologically detected reduced intraepidermal nerve fibers in the affected skin areas, reflective of small C/Aδ fiber neuropathy. In one case, improvement in itching and comparable levels of touch‐evoked itch on the affected and contralateral sites were noted after 6 months without any medication, accompanied by restored intraepidermal nerve fibers proven through rebiopsy of the affected site. Reduced intraepidermal nerve fibers could be one of the precipitating factors for postherpetic itch and its associated punctate hyperknesis.