A majority of psoriatic patients suffer from pruritus, but little is known about its mediator. Pruritus of psoriasis was thought to have been predominantly mediated by histamine, but the recent data suggest non-histamine mediators play the major role.
Objective
This paper reviews current published research on the mediators of pruritus in psoriatic patients.
Methods
English articles between 1980 and 2008, using the key words pruritus, psoriasis, itching, mechanism, and mediators, searched on MEDLINE and PubMed, were reviewed.
Results
Histamines appear to play little role in mediating pruritus in psoriatic patients, while other factors such as substance P (SP), nerve growth factor (NGF) and calcitonin gene-related peptide (CGRP) were shown to be more convincingly associated in mediating psoriatic pruritus.
Conclusion
The results indicate the possibility that there exist multiple mediators of pruritus with major involvement of the central nervous system (CNS).
Get full access to this article
View all access options for this article.
References
1.
KooJ.Population-based epidemiologic study of psoriasis with emphasis on quality of life assessment. Dermatol Clin.1996: 14(3); 485–96.
2.
HuertaC., RiveroE., RodríguezL.A.Incidence and risk factors for psoriasis in the general population. Arch Dermatol.2007: 143(12); 1559–65.
3.
ZamirskaA., ReichA., Berny-MorenoJ., SalomonA., SzepietowskiJ.C.Vulvar pruritus and burning sensation in women with psoriasis. Acta Derm Venereol.2008: 88(2); 132–5.
4.
DawnA., YosipovitchG.Treating itch in psoriasis. Dermatol Nurs.2006: 18(3); 227–33.
5.
AmatyaB., WennerstenG., NordlindK.Patients' perspective of pruritus in chronic plaque psoriasis: a questionnaire-based study. J Eur Acad Dermatol Venereol.2008: 22(7); 822–6.
6.
SzepietowskiJ.C., ReichA., WiśnickaB.Itching in patients suffering from psoriasis. Acta Dermatovenerol Croat.2002: 10(4); 221–6.
7.
WiśnickaB., SzepietowskiJ.C., ReichA., and OrdaA.Histamine, substance P and calcitonin gene-related peptide plasma concentration and pruritus in patients suffering from psoriasis. Dermatol Psychosom.2004: 5 (2); 73–78.
8.
ReichA., OrdaA., WiśnickaB., SzepietowskiJ.C.Plasma concentration of selected neuropeptides in patients suffering from psoriasis. Exp Dermatol.2007: 16(5); 421–8.
9.
ArckP., PausR.From the brain-skin connection: the neuroendocrine-immune misalliance of stress and itch. Neuroimmunomodulation.2006: 13(5–6); 347–56.
10.
ZegarskaB., LelińskaA., TyrakowskiT.Clinical and experimental aspects of cutaneous neurogenic inflammation. Pharmacol Rep.2006: 58(1); 13–21.
11.
ReichA., OrdaA., WiśnickaB., SzepietowskiJ.C.Plasma neuropeptides and perception of pruritus in psoriasis. Acta Derm Venereol.2007: 87(4); 299–304.
12.
NakamuraM., ToyodaM., MorohashiM.Pruritogenic mediators in psoriasis vulgaris: comparative evaluation of itch-associated cutaneous factors. Br J Dermatol.2003: 149 (4); 718–30.
13.
RemrödC., Lonne-RahmS., NordlindK.Study of substance P and its receptor neurokinin-1 in psoriasis and their relation to chronic stress and pruritus. Arch Dermatol Res.2007; 299(2): 85–91.
14.
Schulte-HerbrüggenO., Fölster-HolstR., von ElstermannM., AugustinM.Clinical relevance of nerve growth factor serum levels in patients with atopic dermatitis and psoriasis. Int Arch Allergy Immunol.2007; 144(3): 211–6.
15.
ChangS.E., HanS.S., JungH.J., ChoiJ.H.Neuropeptides and their receptors in psoriatic skin in relation to pruritus. Br J Dermatol.2007; 156(6): 1272–7.
16.
SonkolyE., MullerA., LauermaAlIL-31: a new link between T cells and pruritus in atopic skin inflammation. J Allergy Clin Immunol.2006; 117(2): 411–7.
17.
TakaokaA., AraiI., SugimotoM.Involvement of IL-31 on scratching behavior in NC/Nga mice with atopic-like dermatitis. Exp Dermatol.2006; 15(3): 161–7.
18.
MadejA., ReichA., OrdaA., SzepietowskiJ.C.Vascular adhesion protein-1 (VAP-1) is overexpressed in psoriatic patients. J Eur Acad Dermatol Venereol.2007; 21(1): 72–8.
19.
JaakkolaK., NikulaT., HolopainenR.In vivo detection of vascular adhesion protein-1 in experimental inflammation. Am J Pathol.2000; 157(2): 463–71.
20.
OhmuraT., TsunenariI., HayashiT.Role of substance P in an NC/Nga mouse model of atopic dermatitis-like disease. Int Arch Allergy Immunol.2004; 133(4): 389–97.
21.
SmithP.A., MoranT.D., AbdullaF.Spinal mechanisms of NPY analgesia. Peptides.2007; 28(2): 464–74.
22.
StänderS., SchmelzM.Chronic itch and pain—similarities and differences. Eur J Pain.2006; 10(5): 473–8.
