Post herpetic itching--a treatment dilemma

The Clinical Journal of Pain
Valentina Semionov, Pesach Shvartzman

Abstract

To present a case of severe disabling postherpetic itching (PHI) and discuss possible mechanisms and management. We report on a 22-year-old male patient with a history of non-Hodgkin lymphoma, chronic renal failure peritoneal dialysis dependent, presented with a disabling pruritus around his left eye and forehead. Two months before, he was diagnosed with herpes zoster ophtalmicus. His itching intensity was 10/10 on a visual analog scale and he reported no pain. The neurologic examination showed a hyposensitivity to touch around his left eye. Our patient suffered of PHI who responded successfully to a combination of antihistamine and an antiepileptic agent. The mechanism of postherpetic neuralgia and PHI are not well understood and no single best treatment for postherpetic neuralgia and PHI is known. Clinical experience suggested that neuropathic itch may be more resistant to treatment than neuropathic pain. This immunocompromized patient with a severe disabling PHI responded to antihistaminic and anticonvulsant treatment.

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Citations

Apr 10, 2013·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Gang XuGang Xiao Xu
Jun 1, 2010·Dermatologic Clinics·Jamison D FeramiscoMartin Steinhoff
Feb 27, 2014·Biochimica Et Biophysica Acta·Andreas E KremerRonald P J Oude Elferink
Jul 30, 2009·The Journal of Pain : Official Journal of the American Pain Society·Gordon J WoodGil Yosipovitch
May 7, 2020·Pain Practice : the Official Journal of World Institute of Pain·Gang XuKai Hua Ding
Jan 12, 2019·Pain Research & Management : the Journal of the Canadian Pain Society = Journal De La Société Canadienne Pour Le Traitement De La Douleur·Rie IshikawaEiichi Inada
Apr 5, 2020·Pathogens·Kathlyn Laval, Lynn W Enquist
Mar 25, 2020·JA Clinical Reports·Nobuhiro ShimadaMamoru Takeuchi
Feb 19, 2021·Clinical Case Reports·Soumya PatnaikGabor Varadi

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