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Pediatr Dermatol. 2015 Sep-Oct;32(5):628-34. doi: 10.1111/pde.12486. Epub 2014 Dec 29.

Evaluation of Treatments for Pruritus in Epidermolysis Bullosa.

Author information

1
Department of Dermatology, School of Medicine, Stanford University, Palo Alto, California.
2
Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
3
Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
4
Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
5
Department of Dermatology, University of Colorado School of Medicine, Aurora, Colorado.
6
Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado.
7
Department of Dermatology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
8
Department of Dermatology, Columbia University Medical Center, New York, New York.
9
Department of Pediatrics, Columbia University Medical Center, New York, New York.
10
Department of Dermatology, Dell Children's Medical Center of Central Texas, Austin, Texas.
11
Department of Dermatology, University of Rochester Medical Center, Rochester, New York.

Abstract

Pruritus is a common complication in patients with epidermolysis bullosa (EB). There is limited published data about the treatments that individuals with EB use for pruritus. The objective of the current study was to determine quantitatively which treatments individuals with EB have used for pruritus and to evaluate the perceived effectiveness of these treatments in pruritus relief. A questionnaire was developed to evaluate the treatments and therapies used for pruritus in patients of all ages and for all types of EB. Questions about bathing products, moisturizers, topical products, oral medications, dressings, and alternative therapies were included. A 5-point Likert scale (-2 = relieves itch a lot, -1 = relieves itch a little, 0 = no change, 1 = increases itch a little, 2 = increases itch a lot) was used to evaluate perceived effectiveness. Patients from seven North American EB centers were invited to participate. Greasy ointments (53.4%), lotions (45.2%), creams (40.4%), and oral hydroxyzine (39.0%) were the most frequently used treatments for pruritus. Treatments that were used frequently and perceived to be the most effective included creams (mean = -1.1), topical prescription corticosteroids (mean = -1.0), oils (mean = -0.9), oral hydroxyzine (mean = -0.9), topical diphenhydramine (mean = -0.9), and vaporizing rub (menthol, camphor, eucalyptus) (mean = -0.9). Systemic opioids (mean = 0.3), adherent bandages (mean = 0.3), and bleach baths (mean = 0.2) slightly increased pruritus. Randomized controlled trials of therapies will be necessary to develop evidence-based recommendations for control of pruritus in individuals with EB.

PMID:
25557557
PMCID:
PMC5079440
DOI:
10.1111/pde.12486
[Indexed for MEDLINE]
Free PMC Article

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