Abstract
Chronic pruritus of unknown origin (CPUO) is defined as itching lasting more than 6 weeks in the absence of discernible skin lesions. Pregabalin is used to treat patients with CPUO. In this study, we aimed to investigate differences in the perception threshold of itch sensation between patients with CPUO and healthy individuals and to evaluate the efficacy of pregabalin for CPUO. At baseline, week 2, and week 4 after treatment initiation, the visual analogue scale (VAS) score was measured to assess pruritus severity, and electric current perception threshold (CPT) was measured at 250 and 5 Hz using a NEUROMETER CPT/C stimulator. Twenty healthy individuals and 41 patients with CPUO were enrolled in this study. The patients with CPUO were categorised as those who responded to antihistamines (Antihistamine group), were not improved by antihistamines (Pregabalin group), and were not improved by antihistamines and pregabalin (Refractory group). The baseline CPT values were not significantly different between patients with CPUO and healthy control. Pruritus was improved in 7 of 10 patients in the Pregabalin group after treatment with pregabalin, showing decreased CPT at 5 Hz. The sensitive C-fibres presented a high threshold to detect itch sensation, and this sensitivity decreased in response to treatment with pregabalin.
Highlights
Chronic pruritus of unknown origin (CPUO) is defined as itching lasting more than 6 weeks in the absence of discernible skin lesions
Seven of the 10 patients in the Pregabalin group reported an improvement in pruritus, we detected no significant differences in the current perception threshold (CPT) values at 250 Hz between 2 and 4 weeks
At 4 weeks (2 weeks after commencing pregabalin treatment), there was a significant decrease in the CPT values at 5 Hz on one forearm compared with those recorded at 2 weeks (Fig. 3)
Summary
Chronic pruritus of unknown origin (CPUO) is defined as itching lasting more than 6 weeks in the absence of discernible skin lesions. We aimed to investigate differences in the perception threshold of itch sensation between patients with CPUO and healthy individuals and to evaluate the efficacy of pregabalin for CPUO. Week 2, and week 4 after treatment initiation, the visual analogue scale (VAS) score was measured to assess pruritus severity, and electric current perception threshold (CPT) was measured at 250 and 5 Hz using a NEUROMETER CPT/C stimulator. To the best of our knowledge, no study has evaluated the CPT in patients with CPUO during pregabalin treatment and compared their baseline data with those of healthy people. We attempted to confirm, using the visual analogue scale (VAS) and CPT, the effect of pregabalin on patients with CPUO who were unresponsive to topical steroids and oral antihistamines. We investigated whether there are any differences in the CPT between patients with CPUO and healthy individuals
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