Investigation of the Correlation between Postherpetic Itch and Neuropathic Pain over Time.

Rie Ishikawa,Masako Iseki,Eiichi Inada,Rie Koga

doi:10.1155/2018/9305126

Rie Ishikawa, Masako Iseki + Show 2 more

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https://doi.org/10.1155/2018/9305126

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Abstract

Postherpetic itch (PHI), or herpes zoster itch, is an intractable and poorly understood disease. We targeted 94 herpes zoster patients to investigate their pain and itch intensities at three separate stages of the condition (acute, subacute, and chronic). We used painDETECT questionnaire (PDQ) scores to investigate the correlation between PHI and neuropathic pain. Seventy-six patients were able to complete follow-up surveys. The prevalence of PHI was 47/76 (62%), 28/76 (37%), and 34/76 (45%) at the acute, subacute, and chronic stages, respectively. PHI manifestation times and patterns varied. We investigated the relationship of PHI with neuropathic pain using the visual analog scale (VAS), which is a measure of pain intensity, and the PDQ, which is a questionnaire used to evaluate the elements of neuropathic pain. The VAS and PDQ scores did not differ significantly between PHI-positive and PHI-negative patients. A large neuropathic component was not found for herpes zoster itch, suggesting that neuropathic pain treatments may not able to adequately control the itch. Accordingly, we suggest that a more PHI-focused therapy is required to address this condition.

Highlights

We have been investigating postherpetic pains focusing the nature of such pains [1], during which we have noticed many patients suffering form postherpetic pains suffer from itch
Our clinical experiences with both the itch and pain indicate that the treatments for postherpetic pain have little effect on itch, which sometimes persists being refractory to any treatments. is itching is termed postherpetic itch (PHI) and is clinically experienced in the following four ways: (1) as a transient itch at the time of rash healing, (2) as itching concomitant with pain, (3) as a sensation of itching that intensifies as pain subsides, and (4) as the sole persistent symptom
In an epidemiological study in herpes zoster patients conducted by Oaklander et al, itching occurred in 9% of patients at the acute stage, and the prevalence of PHI ranged from 30% to 58% at the chronic stage in patients who had developed PHN [3]

Summary

Introduction

We have been investigating postherpetic pains focusing the nature of such pains [1], during which we have noticed many patients suffering form postherpetic pains suffer from itch. Ey were studied beginning between 8 days and 1 month after the onset of herpes zoster In this prospective study, the patients were surveyed using the PDQ and a visual analog scale (VAS) to evaluate pain intensity and an 11-point scale (0 to 10) to determine itch intensity. Patients were asked to complete the PDQ at the start of treatment, and the VAS score and itch intensity were determined at the same time. A score of 1 point or greater on the itch intensity assessment scale was taken to indicate PHI, and PHI prevalence and manifestations were investigated for each stage of the illness. Chronic stage patients with a VAS score above 30 mm were regarded as having PHN, and we investigated the association between PHI status and PHN status. Statistical analyses were performed using SPSS Statistics 22.0 for Windows (IBM Corp., Japan)

Results

Discussion

Conclusion