Abstract
Post-burn pruritus is the pruritus that occurs after burn during the rehabilitation and healing process of burn wounds. The post-burn pruritus is a common and serious complication of burn injury, which severely lowers the quality of life of the patient. Many potential treatments are available for pruritus but there is no consensus of the best single treatment yet. The precise mechanism of post-burn pruritus has not been elucidated, but it appears to have pruritogenic and neuropathic aspects. Clinically, post-burn pruritus tends to be intractable to conventional treatment but rather responds to neuroleptic agents, such as gabapentin and pregabalin. During wound healing, various neuropeptides secreted from the nerves of the skin control epidermal and vascular proliferation and connective tissue cells. When keratinocytes are activated by an itch-inducing substance, they secrete a variety of inflammatory substances that increase the susceptibility of the itch receptor. There are two mechanisms underlying post-burn neuropathic pruritus. The first one is peripheral sensitization. The second one is the intact nociceptor hypothesis. An effective treatment for post-burn pruritus will also be effective in other neuropathic and intractable itching. In this review, we summarized the interaction and mechanism of keratinocytes, immune cells, and nerve fibers related to post-burn pruritus.
Highlights
Post-burn pruritus is the pruritus that occurs during the wound healing process after a burn
In case of drug allergies to these drugs, it is usually accompanied by severe itching, which is difficult to differentiate from post-burn pruritus
A study using a eutectic mixture of local anesthetics (EMLA) on healed but pruritic burn lesions showed a decrease in the number of pruritic episodes and antihistamine breakthrough doses compared with controls [54]
Summary
Post-burn pruritus is the pruritus that occurs during the wound healing process after a burn. There are many sensory discomforts including prickling, burning sensation, numbness, and stinging that occur in the post-burn state. Post-burn pruritus is a very common and distressing problem affecting individuals afflicted by a burn injury. Itching has been shown to affect the quality of life of people with burns in aspects such as sleep disturbance, impairment of daily activities, and psychosocial well-being [3]. Some studies show that the distress from pruritus can affect the quality of life and mental health and even induce suicidal ideas with high odds’ ratios (OR up to 1.4–3.1) [6,7]. There are many potential treatments available for pruritus, there is not yet a consensus on the best single treatment
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