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Relations between a standardized experimental stressor and cutaneous sensory function in patients with chronic pruritus and healthy controls: an experimental case–control study

BACKGROUND: While chronic pruritus (CP) is a frequent symptom, many aspects of its underlying pathophysiological mechanisms still need elucidation. Research on sensory cutaneous function and on the influence of stress has been conducted mainly in patients with atopic dermatitis but is lacking for pa...

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Autores principales: Schneider, G., Stumpf, A., Burgmer, M., Volmering, L., Broecker, P., Ständer, S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6585676/
https://www.ncbi.nlm.nih.gov/pubmed/29706009
http://dx.doi.org/10.1111/jdv.15030
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author Schneider, G.
Stumpf, A.
Burgmer, M.
Volmering, L.
Broecker, P.
Ständer, S.
author_facet Schneider, G.
Stumpf, A.
Burgmer, M.
Volmering, L.
Broecker, P.
Ständer, S.
author_sort Schneider, G.
collection PubMed
description BACKGROUND: While chronic pruritus (CP) is a frequent symptom, many aspects of its underlying pathophysiological mechanisms still need elucidation. Research on sensory cutaneous function and on the influence of stress has been conducted mainly in patients with atopic dermatitis but is lacking for patients with CP. OBJECTIVE: To assess whether a standardized social stressor influences cutaneous sensory function in patients with CP in comparison with healthy controls (HC). METHODS: Case–control study; 33 CP and 30 HC were submitted to the standardized quantitative sensory testing protocol before and after the Trier Social Stress Test and 1 h later. Intraepidermal nerve fibre density (IENFD) was determined. RESULTS: Mechanical pain sensitivity and mechanical detection thresholds were significantly higher in CP than in HC, and mechanical detection thresholds increased more in CP than in HC over the three measurements. In both groups, cold pain threshold increased and heat pain threshold decreased from before to after the stress test and remained constant 1 h later. Only in CP, almost all QST tests induced at least a small amount of pruritus, which was not significantly altered by the stress test. IENFD in pruritic skin was significantly reduced in CP when compared to healthy controls. CONCLUSION: Peripheral thermal sensory function was not altered in CP despite reduced IENFD in lesional skin, but we could demonstrate central sensitization processes specifically in CP and influences of an acute stressor inducing more sensitivity to thermal pain in both groups.
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spelling pubmed-65856762019-06-27 Relations between a standardized experimental stressor and cutaneous sensory function in patients with chronic pruritus and healthy controls: an experimental case–control study Schneider, G. Stumpf, A. Burgmer, M. Volmering, L. Broecker, P. Ständer, S. J Eur Acad Dermatol Venereol Allergy, Eczema and Pruritus BACKGROUND: While chronic pruritus (CP) is a frequent symptom, many aspects of its underlying pathophysiological mechanisms still need elucidation. Research on sensory cutaneous function and on the influence of stress has been conducted mainly in patients with atopic dermatitis but is lacking for patients with CP. OBJECTIVE: To assess whether a standardized social stressor influences cutaneous sensory function in patients with CP in comparison with healthy controls (HC). METHODS: Case–control study; 33 CP and 30 HC were submitted to the standardized quantitative sensory testing protocol before and after the Trier Social Stress Test and 1 h later. Intraepidermal nerve fibre density (IENFD) was determined. RESULTS: Mechanical pain sensitivity and mechanical detection thresholds were significantly higher in CP than in HC, and mechanical detection thresholds increased more in CP than in HC over the three measurements. In both groups, cold pain threshold increased and heat pain threshold decreased from before to after the stress test and remained constant 1 h later. Only in CP, almost all QST tests induced at least a small amount of pruritus, which was not significantly altered by the stress test. IENFD in pruritic skin was significantly reduced in CP when compared to healthy controls. CONCLUSION: Peripheral thermal sensory function was not altered in CP despite reduced IENFD in lesional skin, but we could demonstrate central sensitization processes specifically in CP and influences of an acute stressor inducing more sensitivity to thermal pain in both groups. John Wiley and Sons Inc. 2018-08-05 2018-12 /pmc/articles/PMC6585676/ /pubmed/29706009 http://dx.doi.org/10.1111/jdv.15030 Text en © 2018 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Allergy, Eczema and Pruritus
Schneider, G.
Stumpf, A.
Burgmer, M.
Volmering, L.
Broecker, P.
Ständer, S.
Relations between a standardized experimental stressor and cutaneous sensory function in patients with chronic pruritus and healthy controls: an experimental case–control study
title Relations between a standardized experimental stressor and cutaneous sensory function in patients with chronic pruritus and healthy controls: an experimental case–control study
title_full Relations between a standardized experimental stressor and cutaneous sensory function in patients with chronic pruritus and healthy controls: an experimental case–control study
title_fullStr Relations between a standardized experimental stressor and cutaneous sensory function in patients with chronic pruritus and healthy controls: an experimental case–control study
title_full_unstemmed Relations between a standardized experimental stressor and cutaneous sensory function in patients with chronic pruritus and healthy controls: an experimental case–control study
title_short Relations between a standardized experimental stressor and cutaneous sensory function in patients with chronic pruritus and healthy controls: an experimental case–control study
title_sort relations between a standardized experimental stressor and cutaneous sensory function in patients with chronic pruritus and healthy controls: an experimental case–control study
topic Allergy, Eczema and Pruritus
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6585676/
https://www.ncbi.nlm.nih.gov/pubmed/29706009
http://dx.doi.org/10.1111/jdv.15030
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